ADHD Myth Busting

Week 4’s video to honor ADHD Awareness Month tackles common myths about ADHD.

Common Myths that are NOT True:

  • 1. ADHD is just bad behavior from poor parenting.
  • 2. If you can focus for a long time you don’t have ADHD.
  • 3. Eliminating sugar and eating clean will fix ADHD.
  • 4. People always outgrow ADHD.
  • 5. Successful people can’t have ADHD.
  • 6. Smart people can’t have ADHD.
  • 7. The medications to treat ADHD will lead to drug abuse.
  • 8. ADHD is just an excuse for laziness. They should just try harder.

Resources:

Did you miss the first 3 weeks?

What’s the best ADHD treatment?

Week 3 of ADHD Awareness Month’s question is one of the most commonly asked:

What’s the best treatment for ADHD?

If you missed the first two weeks:

  1. What are Executive Functions and how are they related to ADHD?
  2. What does ADHD look like at different ages?

Resources:

CHADD’s Toolkit has fantastic information and printables: https://chadd.org/nrc-toolkit/

Parent to Parent: Family Training on ADHD provides parents with a comprehensive understanding of ADHD as well as strategies to improve life at home and school.https://chadd.org/parent-to-parent/

Understood (use their search bar for ADHD)

Healthy Children and ADHD (AAP site)

Finding the Best ADHD Medication You Can Afford

Finding the best medication for ADHD management includes finding one that is affordable. Is a generic version the answer?

If you’ve had problems finding a medication for ADHD that you can afford, you’re not alone. In years past generic medications were equivalent to the name brand and were always a lot cheaper.

Not anymore.

In recent years many new versions of methylphenidate (ritalin) and amphetamines (adderall) have come on the market and generic versions of many of the older medicines have become available.

The FDA has rules that generic medications must have the same amount of active ingredient and be available in the same forms (pill vs liquid) as the original medication. They can often be sold at a much lower cost because the company does not need to spend money researching and developing the medicine. They also offer competition to the original company, which can bring costs down.

Types of Medications for ADHD

A very useful resource that has ADHD medications grouped by type, dosages offered, if they have generic versions available, if they can be put into food or drink, and more is available from the Cohen Children’s Medical Center. This fantastic list of medications can help you and your doctor look at your insurance medication list to pick a medication that is affordable.

Most often the short acting medications are less expensive than the long acting medications. The short acting medications typically last 3-4 hours, whereas the long acting medications last 6-12 hours. Because it is difficult to take medications mid-day for many people, the long acting medications are typically favored.

In general there are stimulants (amphetamines and methylphenidates) and non stimulants (atomoxetine, guanfacine, and clonidine) that are approved to treat ADHD.

Stimulants are controlled substances because they have the potential to be abused and misused. When they are used appropriately for ADHD they have been shown to help prevent drug and alcohol abuse but they require close monitoring by the prescriber.

Which treatment should be first?

This article is about medical treatments, but that does not mean that behavioral therapy isn’t helpful. For preschool aged children, parent training in behavior management is the first treatment preferred. Parent training in behavior management is recommended for at least a part of the treatment regimen for children of all ages with ADHD.

The American Academy of Pediatrics ADHD Guidelines recommend stimulants as first line medical treatment in most instances. One is not preferred over the other. Individuals may respond better to one type of medication over another, but until the medications are tried, it can be difficult to know which will work best.

Family history can help. If a parent or sibling does best on one type of medication, it makes sense to try that medication first.

Pharmacogenetic testing is specifically not recommended in the most recent guidelines. Most insurance companies will not pay for this expensive testing because it has not been shown to be beneficial.

It is important to have close follow up with your prescriber with new medications and routine follow up as long as medications are used. These visits should assess how well they’re working as well as any side effects noted. It can take several medication trials before the right one is found.

If you have side effects, learn to manage them in Tips to Manage ADHD Medication Side Effects.

Please be patient with this process.

I’m a pediatrician who treats many with ADHD, but when my own child was starting treatment it took a few tries before we found the right one. I talk about this and more in A Conversation About ADHD.

Stimulants

Side effects are similar with both types of stimulants, but some people tolerate one medication better than another.

Common side effects include appetite suppression, sleep problems, headaches, stomach aches, and mood changes.

Most of the time either a dose adjustment or change in medication can help alleviate the side effects.

Encouraging eating at times the medication is not active can help with the daytime appetite decrease.

Amphetamines

Common long acting amphetamines include Adderall XR, Vyvanse, and Dexedrine spansules. There are others, such as Adzenys XR and Dyanavel, that do not have generic versions available.

Adderall XR is a long acting medication composed of dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate. This is often referred to as mixed amphetamine salts. It lasts about 8-10 hours.

Vyvanse is a prodrug that lasts 10-12 hours. Prodrug means that it is chemically inert until it interacts with an acid in the gastrointestinal tract. It does not have any mood altering effects if it is crushed, injected or snorted, so it does not have the resale value of other stimulants. This is a potential reason that some insurance companies prefer this over more expensive medications.

Dexedrine spansules are made up of dextroamphetamine sulfate. They are less commonly used compared to Adderall XR, but they are available as a generic and name brand. The long acting form lasts about 8 hours.

Methylphenidates

There are several long acting methylphenidate medicines that have generic versions. These include Concerta, Metadate ER, Focalin XR, Ritalin LA and Metadate CD. (There are others that do not yet have generic versions.)

Metadate CD releases methylphenidate from beads (30% immediate release and 70% extended release) to mimic the effect of 2 doses of immediate-release methylphenidate.

Ritalin LA is also a once-daily agent designed to mimic the effect of the 2 doses of immediate-release methylphenidate. The capsule releases methylphenidate from beads: 50% immediate release and 50% delayed release. It tends to last about 6-8 hours, so it isn’t sufficient for a full school day plus homework for most kids.

The active ingredient in Focalin XR is similar to ritalin, but half of the ritalin molecule is removed, which often helps minimize the side effects. Focalin XR is a 50% immediate-release and 50% delayed-release agent that is similar to using the immediate release Focalin twice a day.

Concerta uses a unique mechanism to release the medication over time. There is an outer covering that immediately starts working, followed by a chamber that slowly and consistently releases medicine over the next several hours. It tends to work for a total of 10-12 hours and avoids the mid-day drop in effectiveness that is common to other forms of long acting medicines.

Generic for Concerta

Unfortunately the laws regarding generic substitutions were written before some of the new technology of medication was invented. The FDA is once again allowing substitutions that use a different delivery system than the original Concerta. I discuss this separately on my other blog if you want more information.

If you’ve noticed a change in your medicine, please keep track of any differences you notice in effectiveness and side effects. If these differences are significant, share this with the FDA. It is easy to file a MedWatch report online – just follow this link and follow the instructions on that site.

It can take a while for enough reports to be filed to trigger an investigation, but it’s the best way to alert them. If they investigate and find that there are sufficient differences, they will remove a generic version. This is what happened in 2014-2016 when the FDA took steps toward removing two generic versions of Concerta.

For more:

Please see Gina Perry’s most recent article on generics for Concerta – it’s worth the time if you take Concerta or one of its generics!

Authorized Generic Concerta – Yet another update

Non-Stimulants

Atomoxetine

Atomoxetine is a non stimulant approved to treat ADHD and has been available as a generic since 2017.

Side effects of atomoxetine include stomach aches, sleepiness, slowed growth (during the first 2 years of treatment), and rarely hepatitis.

Blood Pressure Medicines

Guanfacine and clonidine affect the blood pressure and heart rate. Both are available in short and long acting forms and have generics available.

They can lead to tiredness, dry mouth, dizziness, irritability, headache, and abdominal pain. Most of these side effects are minimized by slowly increasing the dose. Neither should be stopped abruptly due to side effects.

Checking Prices

Of course cost is not the only thing to consider when choosing a medication, but if you cannot afford it, you will not be able to continue it. It must be affordable to be a reasonable choice.

There are two things you must check to estimate how much a medication will cost.

Online resource

One resource to find the cash price is GoodRx. This site allows you to search for any medication and lists how much various pharmacies charge. It also allows you to print out coupons, which may or may not be able to be used with your insurance. They often have a link to less expensive alternatives, which is a very helpful function to estimate if you will be able to afford a medication.

Here’s a screenshot of checking GoodRx. The coupon for Quillivant XR is still pretty expensive, but sometimes it is much cheaper than paying using insurance.
In this example, you can see that the least expensive place to shop without insurance and with the GoodRx coupon is CVS, but it doesn't tell you what you would pay if you use your insurance. Many people can get this for under $42 if they just use their insurance. #formulary @adhdkcteen
In this example, you can see that the least expensive place to shop without insurance and with the GoodRx coupon is CVS, but it doesn’t tell you what you would pay if you use your insurance. Many people can get this for under $42 if they just use their insurance.

Insurance Details

The second thing to always check before starting a long term medication is your insurance formulary and preferred pharmacy.

The insurance formulary is a list of how much different medications will cost if you use your insurance plan. Some will allow you to use coupons with insurance, some won’t.

If you can identify your insurance company’s preferred pharmacy, it might save you money each month. I’ve had personal experience when this didn’t work, so sometimes it pays to visit different pharmacies.

You will also need to know if you can get your medications cheaper as a 90 day prescription. Many insurance companies will not allow a 90 day supply of controlled substances (methylphenidates and amphetamines) but will allow the non-controlled substances (guanfacine, clonidine, and atomoxetine).

Your prescriber will not know which medication is cheapest for you because each individual insurance plan varies – in other words, one Blue Cross Blue Shield plan differs from another Blue Cross Blue Shield plan. One Aetna plan varies from another Aetna plan. The same with United Healthcare and all the other insurance plans. They have many plans that all sound similar.

I took this screenshot as an example of the various medication lists after searching "BCBS medication." The best way to find your list is to log into your insurance portal and look for it. #formulary @adhdkcteen
I took this screenshot as an example of the various medication lists after searching “BCBS medication.” The best way to find your list is to log into your insurance portal and look for it.

You can often access this list online by logging into your insurance plan’s website. If you cannot find this list, you will need to speak with someone at your insurance company. When you make this call, be sure to have a list of medications to check easily available. I recommend asking about each of the medicines listed on the Cohen Children’s Medical Center ADHD Medication Guide.

When looking at medications, be sure to look for subtle differences, such as an “ER” or “XR” after the name. These indicate a long acting form of a medication and often cost more than the short acting version of the same active ingredient.

Also check the amount in each pill. For example, methylphenidate ER 30mg is probably a generic for Metadate CD, but methylphenidate ER 36mg is a generic for Concerta (though it doesn’t specify which generic). If you’re not sure what all the medications are, bring the full list with you to your ADHD (or any chronic condition) appointments.

Best Bet

Before you start a new medication, if you have new insurance, or if it is the start of a new year, log into your insurance portal to look up medications before your appointment with your prescriber.

This can help prevent the need for multiple prescriptions for medications that are not affordable. You can work with your prescriber to help find the most cost effective medication that will work for you.

For more

For more on affording medications, please see my other blog’s post, Affording Medications.

If you want to learn more about how medications work for ADHD, see Brain Function 101.

If you need to be convinced that ADHD is a real disorder, see Genetics of ADHD.

CHADD offers Parent to Parent training (a form of parent behavior training).

Finding the best medication for ADHD management includes finding one that is affordable. Is a generic version the answer?

10+ Things You Can Do to Stop the Panic

What can you do when worry sets in? How can you stop the panic? Check out these ways to calm the chaos in your mind when you start to worry and panic.

People with ADHD are often overly sensitive or have true anxiety and panic attacks. What can we do to stop the panic?

We all can get stuck in a rut. Catastrophizing is common. When we catastrophize, it’s as if the sky is falling and we lose the ability to cope.

We panic.

Learning to cope when life throws problems and stressors in our way builds our resilience. Being resilient helps us to be successful.

Let’s look at ways to stop the negative thinking of panic.

1. Lean on a friend or family member.

Most of us recognize how good we feel when we help someone else out, yet we hesitate to ask for help. Why is that? When we’re in need, there are many people who can help.

Lean On Me lyrics share a fantastic message. #friends @adhdkcteen

It’s preferable if you can talk to someone who is at least in their mid-20s. Their maturity can offer many benefits. If you’re not sure who you can talk to, think of the many adults in your life who would be happy to listen. Parents, aunts, uncles, grandparents, coaches, teachers, neighbors… there are many people who care about you.

If you choose to talk to a peer, choose wisely. Some people can’t take the pressure of hearing negativity. Others will shut you out. And of course many kids overshare other people’s business, so don’t talk about things that are private with peers.

2. Mindfulness

Practice mindfulness to help with anxiety, focus, and overall healthy well being. @adhdkcteen

Don’t roll your eyes and presume mindfulness won’t help.

Mindfulness trains your brain to be aware of your body and environment without judgement.

Yes, it takes time to learn how to be mindful, but a lot of research shows that mindfulness can help with anxiety, chronic pain, stress, focus, and more.

Mindfulness is often referred to as a practice for a reason. You should practice it often, but there are no right or wrong ways to do it.

If you can’t sit still, don’t. It’s okay to get up and walk while being mindful.

When your brain keeps thinking of things, don’t get upset. Just redirect.

Start simple with breathing. You breathe every day, so you can do this step. Take deep belly breaths. Nice and slow. Focus on the breathing.

For more tips on being mindful with ADHD, see

3. Journal

Journaling can get thoughts out of your head so you can relax. Try it when you're angry, anxious, or can't sleep. It just might work. @adhdkcteen

Sometimes it helps to get your thoughts written. Even if you don’t like to write school papers, journaling can help.

Grab a pen and paper or start typing.

It doesn’t need to be grammatically correct or interesting to anyone else. You can just make word jumbles or lists. If you like poetry, make it into a poem.

Just get your thoughts written down.

There’s a very cathartic benefit towards journaling.

You can even take it a step further and write down things you’re thankful for each day. Gratitude helps our overall mindset, and focusing on gratitude can lift our mood.

4. Color and doodle

Doodling and coloring are very relaxing and can be done nearly anywhere when you need to relax. @adhdkcteen

There’s something really soothing about coloring or just doodling.

You can even use free printables like these online if you want some coloring sheets.

And this is something that can be done nearly anywhere.

5. Sing or listen to your favorite tune

Singing or listening to music are ways to help calm down when anxious or angry. @adhdkcteen

What better way to get into a good mood? Listen to a favorite song. Sing along!

Research has shown that listening to music can reduce anxiety, blood pressure and pain. It can also help sleep quality, mood, mental alertness, and memory.

Pick your favorite feel good songs and make a playlist that you can pull up when needed.

6. Exercise

Exercise should be fun. Find things you love to do and do them. Every day. @adhdkcteen

We’ve all heard that exercise helps our bodies, but many people minimize the value it has for our mental health.

Regular exercise helps our mindset in general, but if you have the opportunity to work out when you’re upset, it can help lift your mood.

Combine numbers 5 and 6 and workout to some great tunes!

7. Change the scene

If you need to change your mood or attitude, change the scene. Get up and walk around. It helps! @adhdkcteen

If you’re getting worked up, it can help to get up and walk around.

Especially if you are worried you will say or do something you’ll regret, leave the situation if you can.

If you can go outside, even better. Fresh air can be mood-lifting.

8. Think about what has gone right.

Even the very worst days have something that went right. Take time every day to think about the positives. What are you grateful for? What went right? @adhdkcteen

We tend to ruminate about what’s wrong. Negative thoughts are all we can think about. We need to learn to stop this rumination.

When you recognize that you’re ruminating, accept that you’re having whatever thoughts you’re having. Recognize that the thoughts might not be accurate and allow the thoughts to pass rather than trying to block them out. Trying to block out negative thoughts will just cause increased intensity of the thoughts you’re trying not to have. You can replace negative thoughts with positive thoughts: what is going right? What is the best possible outcome? How can you turn the situation around?

If this is hard, start to make it a practice to write down at least one thing at the end of each day that went well. Your hard studying paid off. You met a new friend. You had a good hair day. Whatever it is, keeping a list gives you something to reflect upon when you’re really down. Doing this daily also helps your brain practice finding the good in things. Like anything, practice makes things easier. It is really hard to find good things to think about when you’re in a bad place, but it gets easier when you’ve practiced when you’re not in a foul mood.

9. Be silly

Being funny can help raise the mood, but be sure you aren't hurting or insulting anyone in order to make a joke. @adhdkcteen

You have to use this one sparingly.

Obviously in the middle of class you can’t start being silly, but if you’re able to get to a place that you can do a silly dance or anything silly to unwind: do it. Acting the part can help relax you and set the mood.

Be careful to not offend anyone or be hurtful in your humor and silliness.

10. Find perspective

Run through questions that help put your worries into perspective.

  1. What are you really worried about?
  2. How likely is it that your worry will come true? Use evidence to support your answer.
  3. If your worry comes true, what is the worst thing that will happen?
  4. If your worry does come true, what’s the most likely thing that will happen?
  5. If your worry does come true, what are the chances that things will be okay
    1. In one week?
    2. In one month?
    3. In one year?

Try a Thought Record to help get your thoughts in order. Here’s a completed example and one you can use for yourself.

Thought Record from https://www.getselfhelp.co.uk/docs/ThoughtRecordSheet.pdf @adhdkcteen

11. Sensory stuff

There are many sensory items that have been shown to help with anxiety and focus. Find what works for you. @adhdkcteen

Sensory items can help calm our minds. Think of sounds, smells, textures, and visually relaxing things.

  • Squishy play doh or silly putty
  • Textured cloth
  • White noise machines
  • Chewable jewelry – if you don’t know what this is, just search “chewelry”
  • Weighted blanket
  • Noise reducing headphones
  • Rock or sway
  • Run your fingers through a bin of sand, dry rice, or dry beans
  • Aromatherapy – Use candles, diffusers, or scented objects. Jasmine, vanilla and other scents might relax you.
  • Glitter jar – make your own!

Need more?

Cognitive Behavioral Therapy (CBT) is very effective for anxiety management. Ask your physician to help find a good therapist for you.

If you’re not willing or able to work with a therapist, there are some interesting options to try online. These are not meant to replace professional help, but they help to remove the most common roadblocks to working with a therapist: cost, time, and not wanting to talk to a real person. Learning online might help you see what can be done with therapy and open your mind to finding a therapist.

  • Woebot is a free app that uses artificial intelligence to teach CBT. It can help you think through situations and learn about yourself with intelligent mood tracking.
  • MindShift™ CBT uses scientifically proven strategies based on Cognitive Behavioral Therapy (CBT) to help you learn to relax and be mindful, develop more effective ways of thinking, and use active steps to take charge of your anxiety.
  • What’s Up? is a free app currently only available for iOS users using some of the best CBT (Cognitive Behavioral Therapy) and ACT (Acceptance Commitment Therapy) methods to help you cope with Depression, Anxiety, Anger, Stress and more!
  • NEW! Common Sense Media is a well known resource to assess if a movie, game, or other media is appropriate for kids. They now have a list of mental health apps with suggested ages and rankings. Check it out on Common Sense Media Apps to Help Mental Health!

I am not self centered! 9 reasons why.

There are many traits common to people with ADHD that can make them seem self centered or conceited. Learning about them can help loved ones understand behaviors and people with unintended behaviors work on having expected behaviors.

Most people with ADHD are very empathetic and kind, but can come off as self centered and uncaring. Why is there this discrepancy? What can you do to help others realize that you really do care about them and not just yourself?

Many of the traits of ADHD can make a person seem self absorbed. Let’s go over a few of them. Once you understand why you do what you do and how those actions are perceived by others, can you think of ways that you can help others to recognize that your actions do not mean what they seem to mean?

1. Time management and awareness

Many people with ADHD have significant problems with time awareness. This makes it easy to run late. All. The. Time.

When you’re often late to meet ups with friends (or forget about them all together), they can see you as not caring.

Many traits of ADHD, such as poor time awareness, can make a person seem self absorbed. Learn how to make a better impression. @adhdkcteen

What to do about it…

Working on improving time management and organization might be a long process, but it’s worth it.

  • Use post it notes as reminders – put them where you’ll see them when you need them (a note on your backpack to remember your project or in the bathroom to remind you to brush your teeth)
  • Set your alarm to remind you to leave on time (have it go off when you should start putting on shoes and doing other getting ready to leave stuff, not just when you need to leave)
  • Look at your schedule each morning and on Sunday evenings
  • Don’t overschedule – anticipate more time than you’ll need for things so you’re not rushed
  • Ask for help – friends would be happy to help you stay on top of things if you ask

2. Planning

It might not be obvious to others how much mental preparation is needed to shift gears. If you’ve been planning to do something and plans change, it is disappointing. When your mind is finally in the zone and someone interrupts, it’s frustrating.

It’s hard for people to understand why a sudden change in plans is met with resistance. This is especially true when we often seem impulsive. Resistance to change in plans seems contradictory to the impulsiveness that often comes out.

There's a lot of mental preparation that goes into making plans, and for someone with executive functioning problems, changing gears suddenly can be overwhelming. @adhdkcteen

What to do about it…

If you tend to lash out at people when they alter plans, the first step to change the behavior is to recognize it. Learn to recognize triggers. Whenever you note a trigger, learn what you can do to help yourself have a positive reaction.

Have a talk with those close to you about why you don’t like to suddenly change plans. They won’t know how you feel if you don’t share it, and most people who care about you will help accommodate if you understand. You might need to remind them when you’re in the moment, but it’s best to have the first conversation at a time in advance.

3. In the zone

If you’re in the zone getting stuff done, it is really frustrating to be interrupted. You know that you’ll have to re-enter the zone, which can take a long time and a ton of energy.

Most of us know what it feels like to be deep in concentration only to have someone ask a question or make a noise that ruins it. The mental energy to get back into the zone is huge. How do you handle the situation?

Your reaction may not be appropriate – there’s that impulsivity at work. If you yell, blurt unkind words, or try to ignore the interruption, it will not be received well. You will seem self centered if you lash out.

Have you ever been deep in concentration, only to have someone ask a question or make a noise that ruins it? The mental energy to get back into the zone is huge. How do you do it? @adhdkcteen

What to do about it…

Learn to take a few big breaths before you react to a disruption.

Give your mind a chance to settle. You were able to get into the zone once, you can do it again.

A little break can help.

  • Exercise has been proven to help our focus, so if you can take a quick walk – even if just to the bathroom – it might help.
  • Mindfulness can really help here. It needs to be practiced, but it only takes a moment to help clarify your mind. 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 overall.
  • Healthy food can renew your energy. Just be careful to not overeat out of anger or boredom.

More tips to de-stress.

4. Working memory

Working memory is like the RAM in a computer. It’s where information is temporarily held while constructing a sentence or forming an idea, solving an equation, remembering where we put something. If the information is “valuable” we then store it in long term memory, like saving to a disk, from which we can pull the information later. Information that doesn’t seem valuable, such as names or dates, isn’t stored.

Many traits of ADHD, such as poor working memory, can make a person seem self absorbed. Learn how to make a better impression. @adhdkcteen

Forgetting details is common among people with ADHD.

When it comes to forgetting birthdays, anniversaries, and other important dates, it can make you appear uncaring.

Many people with working memory problems fear that their thought will be gone if they don’t blurt it out right away. Unfortunately, interrupting others is socially inappropriate. If you do it often, you come off as self absorbed.

If you struggle to recall your thoughts during an important conversation or lecture, jot stuff down quickly to trigger your memory when the time comes for you to talk. @adhdkcteen

What do do about it…

  • If you struggle to recall your thoughts, jot stuff down quickly to trigger your memory.
  • If you find yourself interrupting others, practice looking for pauses in a conversation. Use that pause to speak your mind.
  • Use reminders. Put important dates and events in your calendar. Look at your calendar daily.
  • Play games that help you practice short term memory.

For more on working memory, see Say Goodbye to “Oh, I forgot”

5. Communication

ADHD can lead to many problems with communication.

As mentioned above, working memory problems can lead to communication problems. If a thought pops into your head, you’re likely to share it right away. It doesn’t matter if someone else is talking. You don’t want to forget it, so you blurt it out.

It’s also common that if someone interrupts when you are talking, you get very upset because it breaks the line of concentration. That’s especially common among people with ADHD because it’s so hard to retain a line of thinking, but people might find it annoying that you interrupt them but won’t tolerate being interrupted.

Maintaining eye contact during a conversation might be really difficult. You might tend to look around the room or out the window when someone’s talking to you. This can be perceived as not paying attention.

A similar issue is found during class when you’re listening to the teacher, but doodling or playing with a button on your shirt. This can make it appear that you’re not paying attention, even when you are.

It’s also really easy for you to become bored with a conversation. This means you might suddenly change the topic to something unrelated. This can make others in the conversation feel that you don’t appreciate what they’re saying. Maybe you don’t. But there are social norms that others can follow that help them wait patiently for others to finish before changing the subject.

It can even be hard for you to keep on track with your own thoughts. You can be talking about one topic, then something leads you astray, leaving others confused. Your brain might be ahead of your words, so your sentences lose their meaning to others.

Eye contact. Distractions. Something triggers a thought. Boredom. Whatever the issue, conversation is hard! @adhdkcteen

What to do about it…

Practice.

It sounds silly, but practice does help. Sometimes we get frustrated with ourselves and just stop trying, but then we never get better at communicating.

Watch others in group settings to see how they interact and how others perceive what they say and do. Replicate the things that are well perceived and avoid doing the things that are not appreciated.

Mantra: don’t interrupt.

6. Sensitivity

It isn’t uncommon for people with ADHD to be overly sensitive. This happens after years of being told you’re doing things wrong, being too loud, forgetting stuff, and the million other ways you get negative feedback.

Rejection sensitivity can lead you to become upset at friends for no apparent reason from their point of view. They might feel like you push them away because they don’t understand that their response hurt your feelings.

Many traits of ADHD can make a person seem self absorbed. If you're overly sensitive, you can turn people away. Learn more @adhdkcteen

What to do about it…

If you’re overly sensitive, read about Rejection Sensitivity.

7. Life of the party?

People with ADHD often seem outgoing because of their unlimited energy and talkative nature, but they also can have trouble being around a lot of people. Too much input and stimulation can be distracting, especially to the ADHD brain.

When people perceive you as the “life of the party” type personality, it can make it difficult to explain why you don’t want to go to an outing or event that will have a lot of people. It might seem to others that you feel above everyone else so don’t want to participate.

Although many people with ADHD seem to be the life of the party due to their high energy and talkative nature, they often have trouble in big groups.  @adhdkcteen

What to do about it…

Have an escape plan to leave early if the crowd is too overwhelming.

If you turn down an invite, be sure to let your friend know why. For example, if the crowd is just too overwhelming, let them know you’d rather do something with a smaller group.

8. Humor

Impulsivity can get us in trouble in the humor department, making people with ADHD seem uncaring and downright mean.

Sometimes saying a “funny” thought that pops into our minds is not the right thing to do. It might feel good to make people laugh, but if that laughter is at the expense of others, you will not be perceived as a nice person.

Impulsively saying things while trying to be funny can make people with ADHD seem uncaring and downright mean. Learn how to be humorous without being hurtful. @adhdkcteen

What to do about it…

Watch for real reactions when people are laughing. Are some people uncomfortable or upset about the joke? Those are the types of jokes that you want to steer clear of.

One good rule of thumb: Don’t make fun of other people or groups of people. You might hurt someone’s feelings, and that is never funny. (Even if it makes some people laugh.)

If you are careful, you can make fun of something temporary or non-identifiable, such as bad drivers or people who fall. This is easier to do if you include yourself in the group, such as joking about a time you fell or walked into a wall.

9. Outside the box thinking: good for leaders, hard on kids

Society and school teach us to conform. We should act as expected. Clothing styles dictate what we should wear.

Many people with ADHD are non-conformists. This can be a great trait because it can lead to new ideas and change. Leaders and inventors are non-conformists. This trait can help you make a difference in the world.

But if the expectation is that you work a math problem showing your work in a specific way, you need to do it that way. If you’re supposed to dress for a formal dinner or a group function, you can come off as uncaring if you show up in attire that doesn’t fit expectations.

Many traits of ADHD can make a person seem self absorbed. Learn what they are and how to make a better impression. @adhdkcteen

What to do about it…

Keep being you!

Think outside the box and create as much as possible, but when a certain behavior is expected, try to conform.

This means if your teacher wants a project done a certain way, do it that way.

If you’re going to a location with a dress code, follow it as much as you can. Don’t wear something that will bring attention to you unless you’re supposed to be the center of attention, such as at your birthday party.

Remember to always stay in your role.

If your role is a student, let the teacher teach. When you earn the role of teacher, you can teach.

When you are the athlete, let the coach coach. If you earn the role of coach, you can coach.

When you hang out in a group, let others help to decide what to do. Take turns. Even if it’s not your choice, try to stay focused on the activity. Don’t let your friends think you think they are boring, even if the activity is boring to you. Find something in it that interests you.

If you’re motivated and learn knowledge as well as people skills along the way, one day you’ll be the leader. Then you can lead. Until then, you will be seen as bossy in a negative way if you try to take charge prematurely or inappropriately.

For more…

Check out what Jessica McCabe has to say about ADHD and relationships

And how to build social skills

Most likely to fail?

Inspiring stories from people who were seen as failures. Others have risen above predictions — and you can too. Rise and thrive!

Do you feel like a failure? Moving forward in life is hard, especially when others tell you you’re not good enough. I often tell struggling kids and their parents that schools make good workers… people who do what they’re told. Teachers want you to show the work in the way they do it. They want you to follow a rubric of instructions. There’s often no room for individuality or ingenuity. In short, school isn’t designed to teach future leaders, inventors, or creators. Continue reading for inspiration if you feel like a failure. Others have risen above predictions — and you can too!

Students who are smart and natural leaders tend to struggle in that box we call school, but can shine in life!

If you’ve heard these things before, there are two options: cave and prove them right or thrive and prove them wrong.

Inspiration from others

Tell me about a time someone told you that you could not do something and you went ahead and succeeded out of spite.— Amanda Deibert 🏳️‍🌈 (@amandadeibert) April 19, 2019

This was posted on Twitter and is a fascinating and inspiring thread. If you need inspiration, read some of the stories below. For even more, click the link above.
Inspiring stories from people who were seen as failures. Rise and thrive! @adhdkcteen #success #adhdkcteen
Inspiring stories from people who were seen as failures. Rise and thrive! @adhdkcteen #success #adhdkcteen
Inspiring stories from people who were seen as failures. Rise and thrive! @adhdkcteen #success #adhdkcteen
Inspiring stories from people who were seen as failures. Rise and thrive! @adhdkcteen #success #adhdkcteen
Inspiring stories from people who were seen as failures. Rise and thrive! @adhdkcteen #success #adhdkcteen
Inspiring stories from people who were seen as failures. Rise and thrive! @adhdkcteen #success #adhdkcteen
Inspiring stories from people who were seen as failures. Rise and thrive! @adhdkcteen #success #adhdkcteen
Inspiring stories from people who were seen as failures. Rise and thrive! @adhdkcteen #success #adhdkcteen
Inspiring stories from people who were seen as failures. Rise and thrive! @adhdkcteen #success #adhdkcteen
Inspiring stories from people who were seen as failures. Rise and thrive! @adhdkcteen #success #adhdkcteen
Inspiring stories from people who were seen as failures. Rise and thrive! @adhdkcteen #success #adhdkcteen
Inspiring stories from people who were seen as failures. Rise and thrive! @adhdkcteen #success #adhdkcteen
Inspiring stories from people who were seen as failures. Rise and thrive! @adhdkcteen #success #adhdkcteen
Inspiring stories from people who were seen as failures. Rise and thrive! @adhdkcteen #success #adhdkcteen
Inspiring stories from people who were seen as failures. Rise and thrive! @adhdkcteen #success #adhdkcteen
Inspiring stories from people who were seen as failures. Rise and thrive! @adhdkcteen #success #adhdkcteen

And when the original poster was asked if she had a story of her own…

Inspiring stories from people who were seen as failures. Rise and thrive! @adhdkcteen #success #adhdkcteen

For more

A secret to happiness

How to have a growth mindset

JOMO

10 Secrets of Productivity

ABCs of stopping negative thoughts and rumination

Tips to manage ADHD medication side effects

Are you struggling to control side effects from your ADHD treatment? Learn some tips to help manage them effectively so you can thrive with ADHD!

With everything we do, we must weigh risks and benefits. Many people with ADHD need help managing their symptoms, and that often includes medications. Unfortunately this treatment can lead to side effects. If we can manage the ADHD medication side effects, the risk to benefit ratio tips toward the benefit side.

1. Appetite suppression

A decreased appetite is common when stimulants, such as methylphenidates or amphetamines, are used. I have seen kids who gain weight better on their medicine because they can actually sit long enough to finish lunch, but most will lose a few pounds when they first start their medication. After the initial drop, most can maintain a healthy weight with some simple adjustments.

Make the most of non-medicine times

I often say that kids on stimulants don’t have eating disorders, but they have disordered eating. They eat at unconventional times.

Before meds kick in

Start your day with a healthy breakfast that includes protein, whole grains and fats. The typical American diet of cereal for breakfast is mostly carbs, which gives quick – but non-sustaining – energy.

Protein, fiber and healthy fats can provide longer-lasting energy.

Don’t limit yourself to “breakfast” foods. If a sandwich or leftovers sound good to you, eat that for breakfast.

As meds wear off

Before hanger sets in, grab a healthy snack at the time you start to feel hungry in the afternoon or evening.

If your parents try to make you wait for dinner, talk to them about how your hunger affects your mood and behavior.

Eating a healthy snack (or call it an appetizer) can help keep those under control. You should still be able to eat dinner, but if it affects your appetite, warm up last night’s dinner as your appetizer each day. You’ll still eat what the family eats, but it will be timed differently. Still sit with your family for the conversation if your hunger doesn’t coincide with the family dinner. Family meals are important!

After school if you’re hungry, grab a mini-meal. Heat up leftovers, make a sandwich, or grab a plant and protein pair.

Healthy pairings:

  • apple slices, grapes, or berries with cheese
  • bell peppers with cream cheese
  • berries and yogurt
  • cucumbers, carrots, bell peppers or snap peas with hummus
  • apple, banana or celery with peanut butter
  • smoothie made with fruits, vegetables, and yogurt
  • broccoli, carrots, cauliflower, snap peas or celery with a yogurt dip
Pair a plant and a protein for healthy eating! www.adhdkcteen.com

If you’re hungry after dinner, again grab a mini-meal type snack, not junk food.

Don’t waste empty calories

If you’re able to eat, pick the healthiest part of the meal first. Don’t start with the side dish or roll. Eat plants and proteins. Plants are fruits and vegetables, and most of us fail to get the recommended amount of these daily.

2. Moodiness

People with ADHD tend to be very sensitive and emotional in general, but medications can increase moodiness at times. Look for patterns about when the moodiness is the worst to help identify why it happens.

Some people get more irritable when their medicine is working, others as it wears off. This can be due to a medicine that’s not the best fit or at the wrong dose. Be sure to talk to your prescriber about how your medicine is affecting your mood.

Rebound

Many people experience a rebound of symptoms as the dose wears off. If this happens, some people can use non-medication changes, others require a medication adjustment.

If you can be alone during this time frame, that may be all you need.

Listen to music. Exercise. Read. Whatever helps you adjust.

If this isn’t sufficient, discuss adjusting the dose or adding a short acting dose in the afternoon with your prescriber.

When these medication adjustments aren’t sufficient, adding a non-stimulant medicine can help buffer the rebound. Again, talk to your prescriber.

Anxiety

Sometimes stimulants can can trigger an underlying anxiety.

Anxiety can look like anger or increase irritability.

It can lead to headaches, stomach aches and other physical symptoms.

Anxiety is a common cause of insomnia. Lack of sleep makes anxiety worse. It’s a hard cycle to break sometimes. Talk to your prescriber if you’re experiencing this.

When anxiety distracts, it can look like poor focus, which can be misintrepreted as too little stimulant. Increasing the stimulant makes it worse.

Anxiety often leads to avoidance, negativity, over planning and trouble with patience.

Help for anxiety

Therapy is the first line treatment for anxiety, but if it is caused by medication, adjusting the medication can help.

Sometimes adding another medication to help with the anxiety may be needed.

It is very important that you talk to your prescriber about any anxiety you have, whether it’s medication related or not. No one should suffer in silence.

Other causes of moodiness

Moodiness can be related to chronic sleep deprivation or hunger – see the related sections of this post to help manage those issues.

3. Sleep problems

Sleep problems are common in teens, especially those with ADHD. Sleep deprivation can lead to many problems, so it’s important to address them.

There are many things we can do to get more sleep. These are covered in How can I get better sleep?

If you think your medicine keeps you up, talk to your prescriber about changes that could help.

4. Stomachaches and headaches

If stomachaches or headaches seem to happen due to the medication, taking the medicine with food can help.

These symptoms sometimes only happen at the start of a new medication, when the dose is increased, or when resuming after being off of it for awhile. If this is the case, you should notice these side effects go away after consistent use.

When the stomachaches or headaches are persistent and not tolerable, talk to your prescriber to discuss changing medicine or changing the dose.

5. Tics

Repeated movements or sounds are known as tics.

Tic disorders are common in kids with ADHD:

  • About 20% of kids with ADHD have chronic tics.
  • Around half of all children with chronic tics have ADHD.

Tics can come and go. They often change over time, so an eye blink can go away and be replaced by a nose twitch or shoulder shrug.

Because of this natural cycle it can be difficult to decide if they’re on their normal cycle or worse due to medication.

While it was once common to believe that stimulants cause tics, there is evidence to the contrary.

Some people will even notice that their tics are less common when they’re on medication for ADHD, especially with guanfacine or clonidine.

If you note that tics increase with the start of a new medicine or an increase in dose, evaluate how these tics affect you. If they are minor, such as an eye blink, it is okay to ride it out. The tic will most likely continue to come and go and it’s not causing distress. If it causes you distress, talk to your presciber about behavioral therapy or a medication change.

6. Psychosis

Recent headlines have put psychosis and stimulants in the news.

Psychosis from Adderall is all over the news. Headlines are scary. Learn what you need to know. @adhdkcteen

In short, if you’re doing well on a stimulant, either amphetamines or methylphenidates, there’s no need to worry.

The study being reported is about new starts on these medications.

As is often the case, headlines are overestimating the risk. They are designed to make you want to read the article.

I am writing a whole post on this, so tune in next time… if you don’t want to miss it, sign up in the pop up or the right sidebar so you’ll get each new post in your in box. I promise to never use your email for any other purpose!

Meds don’t last long enough?

If your medicine doesn’t last long enough for your schedule, check out My Medicine Stops Working Too Soon!

If you still feel like you’re struggling…

Our next meeting will be all about growing up and thriving with ADHD.

Paula Smith-Culp from ADDvantagekc and Jonathan Kindler, a local therapist at Serenity Life Resource Center and KC Wolf alternate, will share their journeys from childhood to adulthood.

This presentation will be of interest for all ages living with ADHD. It will include experiential activities, and guidelines for using ADHD strengths in order to follow your passion from childhood to the workplace!

This will be a combined group of the parents and students. We appreciate your RSVP so we can plan seating, but if you decide to come at the last minute, you’re welcome to show up! All meetings are free and open to the public. RSVP here

ABCs of stopping negative thoughts and rumination

Does rumination and negative thinking keep you from finding appropriate solutions and moving forward? Learn how to overcome negative thinking with ABCs.

We all have negative thoughts, but when we get stuck in a rut about them, it’s called rumination. When we ruminate, we can’t stop thinking the negative thought, which keeps us from finding appropriate solutions and moving forward. Cognitive Behavioral Therapy (CBT) teaches how to break this cycle of rumination. One way to use CBT is to think of your ABCs. Use the handout linked below to stop thinking negative thoughts.

A is for Adversity

When there’s a problem, we need to identify the trigger, or what is causing the adverse situation.

B is for Belief

How we view a problem is not necessarily what is going on. We tend to catastrophize the situation.

C is for Consequences of believing in the negative thought

Notice this does not simply say consequences. It is important to focus on identifying your belief and how it is coloring your view. Not everything we fear is based on reality. Learn to find the facts.

D is for Disputing

Dispute your negative belief. What are alternative ways to look at things?

E is for Energizing

What effect does disputing have on your mood? Is there something you can take from the dispute to use in a positive way?

What does this look like?

Download a free printable to help you work through the ABCs of stopping negative thoughts and ruminating yourself. Stop thinking negative thoughts with the help of this FREE handout.

Check out the following examples to see how the process works.

Situation 1: Your BFF hasn’t answered your important text.

A: Your friend is usually quick to reply and you’re worried that there’s something wrong that’s kept her from replying.

B: You don’t know if she’s mad at you or dead on the side of the road after an accident.

C: You are worried that you did something to anger your friend or that something catastrophic is keeping her from answering.

D: There was no indication that she was upset with you last time you spoke. She is a safe driver and the road conditions are fine. It is possible that she could have forgotten to charge her phone (again). She could have the ringer off. Sometimes texts don’t go through. She might be busy doing something and unable to check messages.

E: Do you feel less anxious realizing there are other reasons that your text has gone unanswered? What about these new thoughts can help you problem solve? Is there another way to reach your friend, such as through her parent or another friend? Should you call instead of text?

Situation 2: Too much to do!

A: Last week you missed a couple days of school so you got behind and can’t quite get back on track. You have a paper due, a huge test this week, and practice every night after school.

B: There’s so much to do, you’re overwhelmed and can’t even start on any of the schoolwork. After practice you want to just relax and watch YouTube videos. You need time to relax to feel better, but then you realize hours later that no work has been done, so you’re going to be up all night working. This leaves you too tired to focus at school so you get confused on even simple concepts and questions.

C: Anxiety is keeping you from initiating what needs to be done. While relaxing is important, you are not using your time efficiently, which is adding to the problem. You’re sleep deprived, which increases anxiety.

D: Take a look at how much time you’re spending on everything. What can be pushed off until later? Where are the priorities? How can you moderate your down time so you can be productive but still have time to relax?

Mindset: This is a situation I have the capacity to deal with. I’ve developed a pattern of avoidant coping but I can get better at non-avoidant coping through the right kind of practice. This is an opportunity for that.

E: Does realizing how much down time you waste help you regroup and use time more efficiently? Are you motivated to set timers to help limit your free time? Can you grab a friend to study together to keep you on track? Are there things you need to change in your schedule so you can devote appropriate time to tasks? Are any of your teachers willing to extend the deadline since you were sick? What can you learn from this to do it better next time?

When we ruminate, we can't stop thinking the negative thought, which keeps us from finding appropriate solutions and moving forward. Learn how to overcome this with ABCs. @adhdkcteen #adhdteen #adhd