Tina*, a 27 year-old married graduate student, presented to my office years ago when I first started my practice. She described chronic anxiety, low mood, and trouble sleeping for the past two years. She had been struggling with “keeping up with it all”. This included her schoolwork, relationship, a part-time job, and her one year old baby. She experienced similar symptoms throughout school, especially as the course load became more challenging.
In the past, she had been diagnosed with anxiety disorders and depression and her doctor tried her on two antidepressants that both caused intolerable side effects. When we met, her top complaints were feeling overwhelmed and discouraged due to struggling in most areas of her life.
After an extensive evaluation, I diagnosed her with ADHD, inattentive type. She did not have depression or an anxiety disorder. She responded extremely well to medication and his mood and anxiety improved as he became more organized and competent in her life.
However, despite ADHD treatment with medications and therapy, she continued to exert significant energy “just to keep up”. This is often true with adults with ADHD.
Therefore, people with ADHD often experience difficulty maintaining their energy. Here are some tips to energize your life as you cope with ADHD. I hope they help you on your journey to success.
1. OBSERVE RUMINATION
Rumination is thinking about the same thing over and over. It can sap your energy and take the “wind out of your sails”. People with Adult ADHD may be more prone to rumination due to difficulty shifting gears.
Attempting to stop the thoughts can often make them persist. Instead, label them as “ruminating thoughts” and turn your focus to another activity. One technique that you may find helping is saying, “Oh…there is obsessing”, or “Oh…there is worry”. Just observe what happens when you name the thought. Research has shown that this can lower the intensity and duration.
2. INCREASE STRUCTURE
People with ADHD often struggle with a cluster of cognitive skills called executive function such as time management, initiating tasks, organization, follow through, and prioritizing. Challenges in executive function can lead to anxiety and feeling exhausted.
Having a schedule or “game plan”, can help one feel calmer. Using a calendar, either paper or digital, can help structure tasks and time. This can help with productivity and organization.
Many people with Adult ADHD often feel they never are going to catch up or achieve their goals. This may be due to painful experiences in the past. You may recognize some of the self-talk:
● “I am always screwing things up”.
● “I will never be good enough”.
● “This will never work for me”.
This type of self-talk is often called the inner critic and can sap energy similar to rumination. Often, I encourage my patients to do the following:
● Notice the inner critic.
● As above, label it. “Oh….There is the inner critic.”
● Remind yourself: “I am a work in progress”.
This may just sound like positive talk or unrealistic, but thousands of studies for many decades have shown that how we talk to ourselves affects how we feel and behave. This concept is the basis of cognitive behavioral therapy (CBT).
4. IMPROVE SLEEP
There has been more attention over the past decade on sleep and the impact of sleep deprivation. Restorative and adequate sleep is important not only for energy but also for cognitive functioning. Sometimes, ADHD symptoms may worsen during periods of interrupted sleep, insomnia, or sleep deprivation.
Some tips to improve intermittent sleeping difficulties include:
● Avoiding electronic devices for three to four hours prior to bedtime.
● Establishing a consistent, evening routine.
● Creating a calm, uncluttered sleeping environment.
● Using earplugs or a white noise machine if needed.
● Exercising during the day and not within three hours of bedtime.
If you suffer from significant low energy during the day or chronic insomnia, it is important to seek treatment from your doctor about potential underlying medical causes of fatigue.
Often, people with ADHD feel so overwhelmed or without enough time that fun or pleasurable activities are ignored. People may say, “I don’t have time to relax or have fun” or “I don’t deserve to do that”. However, fun can energize you and help you have a better outlook and be more productive. Fun can involve watching a comedy, playing with your dog, visiting friends, or pursuing an artistic passion.
6. SET GOALS
Just like a map, having specific goals can help you stay on track. As you make progress in your goals, it can provide momentum and guidance on your journey. I would recommend that you set several create both short-term (e.g. one month) and long-term (e.g. one year) goals.
Effective goals usually have specific outcomes (e.g. increased sales by $10,000 or eating meals with the family three times a week), a game plan or strategy, and most importantly, a means to measure the outcome (e.g. a chart or checklist).
7. CARDIOVASCULAR EXERCISE
Cardiovascular exercise such as biking, running, dancing, swimming and other activities are good for our overall health. In addition, cardiovascular exercise can improve our sense of well-being and energy.
There are many hypotheses why cardiovascular exercise has this benefit including releasing endorphins and increasing a “motivational transmitter” called dopamine.
Adult ADHD can be very challenging as you pursue success in your personal and professional life. However, I hope these seven ideas help to provide you the stamina and energy to achieve your potential.
If you would like to learn more about Adult ADHD and coping strategies, please visit my website at www.scottshapiromd.com.
*Disclaimer: Details of cases have been altered to protect the confidentiality of any and all individuals.