Eleven ADHD Strategies

Caution: this post is roughly 3,000 words in length.

ADHD doesn’t scare people as much as some classical mental disorders, which is a double-edged sword. On the one hand, few assume you’re going to kill their family, but on the other, it’s subtle enough to be overlooked, even in the face of great turmoil.

I’m autistic, but I also have ADHD, and in my particular case, I consider it a larger issue. It’s the difference between looking strange and confusing important deadlines, or wanting to fall asleep all the time, or coming in thirty minutes late to your school’s free ACT session.

It sounds laughable, until you (or other people) suffer the results. But I’ve survived, partly from stimulant therapy, and partly because I’ve learned to compensate. These are eleven strategies and ideas I’ve developed over the years. I won’t claim to follow them perfectly, but they’ve made a difference in my life. I’m not a medical expert, or even old enough to drink, but if you have ADHD, I hope at least a few items here will prove useful.

1: Stay Organized

It can be tiresome to sit down and make a coherent plan for the week, or even the rest of the day, but it saves effort in the long run. With or without stimulants, it’s easy to be overwhelmed if you don’t have structure in your life.

The simpler the organizational strategy, the better, When I receive my syllabus at the beginning of a course, I record the deadlines for each assignment in a simple planner in my backpack. I also list certain weekly chores there, such as laundry and yard work. In the past, I tried to store everything in my head, but I lost many, many assignments that way, and you get a certain sense of accomplishment from visually recording your progress.

I store my actual work in a single red binder, with dividers for each course. Back in grade ten, my geometry class required us to hold onto our completed assignments, and I nearly failed the associated test grade because I lost so many papers in my cavern of a backpack. At one time, it contained two or three binders, two textbooks, and numerous supplies each day, with predictable results. I simplified my system the day afterward.

Similarly, I’ve found it important to leave items in predictable locations, particularly small ones that are easily lost or forgotten. I sleep next to my keys, flip phone, and wallet, I leave my charger in a particular section of my backpack, and I ensure my textbooks are clearly visible on my dresser. It sometimes pays to pack your supplies the night before work or school, since most people are a little sluggish when they first wake up.

As a caveat, I’m a nineteen year-old college student, and those with full-fledged careers may require more detailed strategies.

2: Establish a Reliable Morning Routine

Mornings can be a perilous time, because in addition to ADHD symptoms, you begin with residual fog from your sleep cycle. The first hours of the day should revolve around activating yourself for the challenges ahead. Take a shower, eat breakfast, look over your schedule for the day, talk with your family, drink coffee (if you wish), take your meds (if you’re prescribed any), and complete as many minor tasks as you can. Avoid games, social media, and other recreational electronic use until later, unless you have more willpower than me. On weekends, I sometimes begin the day by running or doing yard work; nothing vanquishes fatigue like the Florida sun.

3: Do Work and Chores Earlier Than Required

When possible, I recommend completing chores and projects a little earlier than strictly required. First and foremost, it gives you padding when you fall behind, or forget a handful of supplies one day, and for someone with ADHD, every bit is valuable. It also makes you look good to teachers and employers, particularly if you’re just starting off, and it’s easier to begin with a good reputation than redeem yourself afterward.

But even beyond those factors, working ahead makes life feel more like a game and less like a struggle. Stimulants increase dopamine themselves, but they also prolong natural release, so it pays to make ordinary work as rewarding as you can. It also helps offset the sensations of failure that many with ADHD are accustomed to. My first grade 12 year was a disempowering experience in numerous ways, but I completed most of my homework days or weeks early, and it was one of the few parts of life I was truly happy with.

4: Get Regular Exercise

Exercise has a wide array of health benefits. It also increases dopamine and norepinephrine activity, which can be useful for ADHD patients. When I started high school, I had to run a mile for soccer tryouts, and I overheated so quickly that my coach sent me home midway through (I didn’t make the team). But I started running between my house and the gas station next summer, and my trips ventured further into town the years afterward. I also joined the track team in grade 10, which I participated in until next fall.

There were a handful of better distance runners at my school, and many at competitions, but I enjoyed seeing my endurance improve, and it seemed to clear my mind afterward. I even received an accommodation in grade eleven that allowed me to run around the football field at lunch. It didn’t work as well as Vyvanse, but it was better than nothing. I dropped out of track that year to focus on homework and writing, a decision I now regret, but I continued running and biking throughout my hometown after school. It’s been years since I played sports, but I try to run or engage in other aerobic activities several times a week. My stimulants appear to function better, and it reduces some of the stress and obsessive patterns they can emit as waste.

5: Don’t Be a Work Martyr

Hard work and dedication are all well and good, until you force yourself to stay up until 2 AM regularly, or hide in your room for seven hours each day writing mathematical equations. Moderate stress enhances productivity, but when you’re working to fill a hole in yourself, everything starts to consume more energy than it should.

Most humans are more effective working forty hours a week than fifty or sixty, because there are other priorities in their life, and they only have so much energy to give. It’s why Henry Ford got away with lowering his workers’ hours to forty from forty-five, and it’s why “work harder” and “accomplish more” are sometimes very different things.

It’s easy to define your worth by your output, particularly when you have ADHD or other disorders. Before I started taking stimulants, my academic performance tanked (by my standards) for almost a year, and I grew to hate myself in progressively elaborate ways. I received my first dose of Vyvanse in the final weeks of grade 11, mere days after two large writing projects. The improvement was immediate. I had no tolerance to either focus or euphoria, and I blew through our final exams with little effort, like I was playing a particularly immersive computer game. But guilt over earlier failures remained, and I still didn’t know how to organize myself, despite what I was now capable of. When school started next year, I didn’t just want to do better, I wanted to redeem myself. I achieved straight A’s, but every remaining error—every missed assignment, unfinished chore, or failed voluntary writing project—felt like a mark of inferiority instead of a simple setback. I performed tasks in front of me with little delay, but between the stimulants and my own obsession with work, I was too pressured to read novels, make friends, outline short stories, or plan for college next year. I couldn’t see beyond the next hour or day, because it forced me to confront parts of myself I was trying to destroy.

In the end, life is simply easier to manage when you don’t hate yourself. Stimulants can promote obsessive thoughts, which makes balance even more essential, at least for me. But even if you don’t take them, you have to know when to give yourself a break. Seek improvement, by all means, but don’t beat your own skull in for forgetting deadlines, or being unable to work for twelve hours without falling flat on your face.

6: Don’t Overthink Your Meds

Amphetamine and methylphenidate are crude instruments. While effective for many people, they can disrupt sleep, increase heart rate, promote anxiety, and create discomfort in other ways. They can also elevate mood, stamina, pain tolerance, and sex drive, even at moderate doses. If you experience some euphoria, don’t agonize over it, as long as you aren’t abusing them. Not everyone does, but in the end, it’s still speed, albeit precisely delivered. My first Vyvanse dose hit very hard, partly because I’d never had amphetamine before, and partly because it broke the fog I’d been carrying around for sixteen and a half years. Stimulants aren’t nearly as exciting now, but I still notice them, particularly after I take a break for a few days.

Similarly, you may wonder if you’re betraying your natural self by taking stimulants, or if you deserve any credit for what you achieve. In the past, I faced some discomfort over those questions. My current take: Adderall, Vyvanse, or Ritalin won’t accomplish much unless you want them to, so they aren’t much different from other tools. But on the subject of nature, your brain and your environment already manipulate you in innumerable chemical ways. Stimulants are unusually stark about it, like ADHD itself, but from dopamine to serotonin, the systems they impact were there in the first place.

In fact, your brain naturally contains a molecule called phenethylamine, which behaves much like amphetamine, albeit shorter-acting. It even serves as the structural backbone for amphetamine, along with Ritalin, cocaine, ephedrine, and a variety of other compounds.

In short, focus on what works, instead of allegiance to primal Nature, or remaining Drug Free. If they don’t work, or make you feel sick, then by all means, stop taking them. But if they do, philosophy is a secondary concern. The same goes for non-stimulants like clonidine.

7: Avoid Electronics Whenever Necessary

Electricity is a lot like magic, except it exists, and computers are some of the most intricate creations of all. They’re also some of the most distracting. Between Internet arguments, social media, television streaming, gaming software, political sites, and online pornography, they offer a black hole of easy, reliable stimulation few activities can match. The blow to focus is threefold: they train you to expect immediate rewards, they present information in overwhelming quantities, and they cause you to sit down for long periods of time.

Whether they’re addictive in the sense of gambling is still up for debate, but a lot of people look at their iPhones a little too much, and the effects range from traffic accidents to lost work output. If electronics don’t impact your focus, I congratulate you. But if you find laptops, smartphones, or other devices intruding in your activities, don’t hesitate to switch them off, leave them at home, delete offending applications, or interrupt the cycle however else you deem necessary. If you feel weak, remember that normal people have issues with them too. In a way, you’re leveling the playing field.

In my experience, it’s usually easiest to break the habit by avoiding them for a few hours. Each use strengthens it, so a definite “no” is better than “I won’t use them quite as much today”. In particular, I no longer bring electronics into my bedroom when I’m trying to sleep, other than my shitty flip phone. It’s too easy to stay up later than I intend, or reach for them the moment I wake up.

8: Use OTC Stimulants Cautiously

Like Adderall, caffeine can improve focus and energy, but the effects on dopamine are much weaker and less direct. Accordingly, it’s less addictive when abused, but also less useful medically. Before I received my first Vyvanse prescription, I self-medicated with tea, energy drinks, Mountain Dew, Vivarin tablets, and a handful of other products. None of them worked very well, and they set my nerves on edge, creating numerous bouts of insomnia, facial tics, and general grittiness. I sometimes consumed over 400 or 500 mg of caffeine in a single day, hoping I would reach a threshold that relieved my symptoms, but I regretted it virtually every time.

At low doses, caffeine might make Adderall or Ritalin work a little better, but it can also worsen tachycardia, blood pressure spikes, and other side effects. Consult with your doctor before combining them. Similarly, nicotine can boost focus and working memory, but tobacco is fiendishly addictive, and quite poisonous over time. The CDC estimates it kills over 480,000 Americans per year, including over 41,000 casualties from secondhand exposure. Nicotine gum and patches are probably less addictive, because they lack the natural MAOIs found in tobacco products, but they still aren’t FDA approved for ADHD treatment. I personally use nicotine gum, which seems to help a little, but I haven’t taken any cognitive tests to verify. I’m not dependent yet, but for all I know, I might regret it in a year or two.

9: Get Enough Sleep

You’re unlikely to reduce your natural need for sleep, so don’t feel bad if you can’t get by on five or six hours. Sleep deprivation is a common problem in America. Some people even brag about it, but it impairs focus and emotional control, much like ADHD itself. In one study, participants who stayed up for 17-19 hours suffered impairment similar to a blood alcohol level of .05, with significantly worse scores on some measures of accuracy. After delaying sleep for, on average, around an hour longer, performance become similar to a BAC of .01. For comparison, the legal driving limit in most U.S. states is .08.

Unsurprisingly, sleep deprivation can lead to traffic accidents. The National Highway Traffic Safety Administration estimates that it caused around 83,000 crashes yearly from 2005 to 2009, including an average of 37,000 injurious crashes and 886 fatal ones. Beyond that, missing sleep decreases productivity in a variety of ways, increases cognitive errors, and generally makes life unpleasant.

On average, adults require somewhere between seven and nine hours of sleep for optimal functioning. Drop below that, and most people will suffer fatigue, disrupted focus, muscle aches, bloodshot eyes, sensitivity to cold, sudden spells of unconsciousness, or even psychotic symptoms, depending on just how much sleep is lost.

Even with stimulants, my life is much harder on four hours of sleep than eight. There were several pre-diagnosis years where I regularly stayed up until 2 or 3 AM before school. This pattern started in grade 8, after my mother got a new job that required us to wake up at 6 AM. My nighttime routine was too complex, as lazy as that sounds. The combination of Proactiv, homework, and reading was too intensive for my tired, unmedicated self to finish until 11 or 12, and then I generally gave up, because my sleep cycle was fucked anyway. I would recommend this pattern to no one, particularly not a child. My eyes burned like bleach rags, my arms were cold and sore, and every day became a nameless, depleted extension of the last. When I later tried to repair my sleep patterns, I had to relearn how to sleep normally, and it took several years to do so.

Later in adolescence, I developed a habit of staying up late writing. It wasn’t as consistently terrible, but it sometimes prevented me from sleeping at all. There are times when you may be forced to sacrifice sleep for work or school assignments, but it should be used as an occasional panic button, not a standard tool.

If you find yourself regularly missing sleep, it’s important to identify the source. Excessive caffeine, ADHD stimulants, smartphones, gaming consoles, alcohol, stress, or overly complex night routines may be the culprit. Amphetamines don’t give me trouble sleeping now, but they did in the past, and nighttime gaming remains very disruptive. If insomnia can be eliminated through changes to home environment or schedule, it’s important to do so. You’re sometimes stuck with your meds, but lowering your dose or switching to another treatment may bring relief.

10: Everyone Thinks They’re a Goddamn Psychologist

Psychology is similar to the Bible, or Donald Trump: you will meet many laymen who behave as though they have studied it for years on top of a mountain. Venture into some circles, and you may hear that ADHD is a gift, offering great energy at the price of a little clumsiness. Stimulant therapy, according to many of this camp, stems from an intolerant society that wants all children to behave in identical ways. Other circles will present ADHD as a scam created to get money from parents, an attempt to label normal childhood, a symptom of excessive television use, an excuse for lazy parenting, or any combination of those factors. The CDC disagrees with them, but you may still wonder how a disorder can be diagnosed in over ten percent of American children. You may also wonder how, even as an adult, you keep making the same mistakes and losing the same items so many times.

Admittedly, you can also purchase books from trained psychologists who don’t believe in ADHD, or oppose stimulant therapy, or think it’s been diagnosed too widely. You can also purchase books from those who uphold the medical model. You can examine brain scans showing differences in ADHD patients, and then you can read articles and forum posts arguing they’re a sign of variation instead of disorder.

I tend to think most humans are a little disordered in some ways (including myself, obviously), but I don’t think you can deny that ADHD symptoms are a problem for many people, whatever the numbers. Nonetheless, if you see persistent evidence of dysfunction in your life, you shouldn’t feel compelled to discount it. Perhaps ADHD is overdiagnosed; perhaps it isn’t. But in the end, you still have to find a solution.

11: Think for Yourself

Don’t feel compelled to follow the opinions of strangers on the Internet, including me. Stimulants, clonidine, exercise, antidepressants, therapy, Internet tales, self-help books—incorporate whatever works, jettison whatever doesn’t. Even qualified doctors disagree on how ADHD should be approached. You should consider different views, but in the end, you’re the one who has to solve it in your own life.

Image Attribution

License: CC BY 2.0
TheDyslexicBook.com. Nov 17, 2017.
Found: https://www.flickr.com/photos/153278281@N07/37764661234/in/album-72157690694372246/

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