Working from home with ADHD

How I got here, and what works for me.

I wish I knew this 20 years ago…

In 2011, I was sitting in a pretty good spot. I just landed a great job with a growing, dynamic company. I had completed a master’s degree a short time ago, and my wife and I had just welcomed our third child into the world. My wife was running a modestly-successful dental practice. We had a nice house in a nice neighborhood, with some of the best people around as neighbors. From the outside, things looked great. By all measures, I was living the middle-class tech worker’s American Dream (without the hugely successful start-up).

On the inside, though, I felt like I was living in a house of cards. Smoke and mirrors. You see, I’ve always been good at switching contexts — changing from one cognitive task to another without needing much ramp-up time on the new task. This ability, along with being able to learn quickly, has, on more than one occasion, saved me. Secondly, I always seemed to thrive when the deadline was imminent. A big project due next week? Whatever. That same project is due tomorrow? I got this. For as long as I can remember, my academic and vocational experiences were like this — impending deadlines that just barely got met with a body of work full of small mistakes, things I didn’t finish, and even more things that I just never started.

I was perpetually working in the “Urgent, but not Important” quadrant of the Eisenhower Matrix, always putting out fires because I couldn’t get ahead on anything. Those times when I received accolades for a job well done, I thought to myself, “If they only knew…”.

My most-often used phrase was, “Sorry, I forgot.” Over the years, simply forgetting something has cause me more problems than I can count. Thank you cards, phone calls, grocery items, bills, enrolling for a semester of college — you name it, and I’ve forgotten to do it. For as long as I could remember, this is how it went. I began to feel as though some things were just too tough for me, that I wasn’t capable of those tasks. After being married for a while, my wife felt the same way — I just couldn’t handle certain things. Naturally, my self-esteem and confidence took a nose-dive.

One day, she came home and said, “You need to go speak with Dr. K (family physician) about ADHD medication or something!” She had been talking to a patient about kids with ADHD and, as the patient was rattling off symptoms she thought, “That’s my husband.”

About 2 months later, I was sitting in a Dr’s office for the third visit of a three-part assessment. The first two visits were a simple interview and then a battery of assessments and tests. That day, I sat listening as he described my life in much the same way a profiler will describe a suspect

• difficulty starting tasks
• makes lots of to-do lists without ever completing any of them
• disorganized
• poor short-term memory for things that aren’t interesting
• frequently losing items
• difficulty managing money
• low self-esteem

The doctor said, “If I lined up 99 people next to you, maybe one of them would score higher than you on this assessment you just took. Clearly, it looks as though you’ve been dealing with ADHD.”

You might find it odd, but I didn’t consider being labelled with ADHD as any sort of justification or excuse for my failures (I still don’t). Nor did I take it as a point of pride that I had succeeded in spite of having ADHD.

Rather, I felt worse about myself. This brought all of those failures back into clear focus. The times I forgot to pay a bill or complete an assignment or go to an appointment or enroll in college all stood out as lost opportunities and wasted potential.

I kept thinking, “If I had known this 20 years ago, how would my life be different?”

A little bit about ADHD

[Much of the following section will be paraphrased from Wikipedia, with my own experiences and editorialization thrown in for good measure. This section is NOT original content. If in doubt, I’ll give credit to the Wikipedia article.]

The technical term is ADHD-Predominantly Inattentive. This subtype is what used to be referred to as simply Attention Deficit Disorder (ADD). This subtype is not the stereotypical image of the hyperactive child — bouncing off the walls and unable to sit still as though driven by a motor. Instead, it is differentiated by directed attention fatigue symptoms. Looking down the list of DSM-5 criteria, I don’t have all of those symptoms, but I have enough to make it uncomfortable to read that list.

There are quite a few pharmacological treatments available. Almost all of them involve taking a stimulant (amphetamine derivative). After 20 years of fighting with myself, I was ready for some help. During the assessment meetings, the doctor asked about my ideal work conditions. Tell me if this sounds familiar — big red bull (usually the 16oz can), some chips/pretzels/crackers, headphones with music loud, and the door to my office shut. As he pointed out, often, people will use caffeine (another stimulant) as an attempt to self-medicate, without even realizing it. I added it up — on a daily basis, I was consuming over 800mg of caffeine — the equivalent of drinking almost an entire 24-pack of Diet Pepsi per day.

Shortly after that last assessment meeting, I began taking Concerta. Working with my physician, we finally settled in on Vyvanse, 50mg per day as the optimal dose. I also cut waaaaay back on the caffeine at the same time.

In a groove

Fast-forward to today, and I’m in the middle of a great run. The past 2 years has been the most enjoyable and productive period of my work career. I’m currently working for MMGY Global in Kansas City, MO, as a Technical Director, running the PHP Dev team. I work from home near Portland, OR and I love my job. The guys on the team are awesome — they have forgotten more about Drupal development than I have learned. My boss is a friend from grad school who gives us the freedom to learn, try new things, and solve problems. While I don’t think I’m knocking it out of the park, and admittedly I still drop the ball on some stuff, I definitely happy.

Working remotely has given me an incredible opportunity to shape and mold my routine and job to fit my personality and tendencies. Working from an office, this wasn’t the case. Drop-ins, overscheduled meetings, and the multiple distractions that come from a “collaborative” work environment were hell for me to deal with.

You are distracted easily and have trouble focusing on a mundane task? Here, sit in the middle of a room full of people and write code while they drop by for water cooler conversations. Let’s see how good you are at switching contexts.

Don’t get me wrong — there have been some times where I was frustrated, miserable, and ready to quit. This time, though, instead of looking to change something (work, hobby, whatever), I went all-in on my daily routine.

That probably sounds strange, but hear me out.

A predictable, repeatable routine

I’m a creature of habit. I like big challenges and doing new things, but I prefer to keep the minutia of my daily routine the same. What I eat for breakfast, how I make the bed, the route I take to drop the kids off at school/daycare, the order of things when I sit down for work in the morning, how I keep notes of things to do, when I pay the bills, etc — I don’t like to vary those that much at all. In the past, when the chaos was approaching, I’d forget those little things and focus on the big, new stuff. This inevitably led to disaster. Now, when the frustration and pessimism set in, I focus on the routine, knowing that a)this “thing” that is causing the discomfort will pass and that b)consistency is the key.

One of the keys to working from home (and I think this applies whether you have ADD or not) is to have a consistent, repeatable routine.

Here is my routine, more or less

• 6:30am — I get up and get ready before the kids (this means shower and get dressed as though I was going into the office in KC — no pajamas, and pants are required). Then I get them ready and off to school.
• 8:00am — Make my blueberry oatmeal from Trader Joe’s and brew a cup of coffee. While those are working, I’ll fire up the computer. About the time that breakfast is ready, my machine is ready, too. While eating and drinking my coffee, I review my to-do list and read any emails that came in over night.
• 8:50am — Put last kid on bus to 3rd grade.
• 9:00am — Now that the animals are out of the house, I can work on the priority stuff with some @#$& peace and quiet!
• 11:00am — Gym, run, or both, depending upon the day.
• 12:30pm — Eat lunch (usually one of three meals) at the computer while working the list
• 3:40pm — 3rd grader gets home from bus. Get him started on homework and/or out of my hair — only about an hour left to be productive!
• 4:00pm — Sometimes I need to pick up 7th grader from school if he had a club or practice.
• ~5:00pm — Review todo list and plan tomorrow.
• 5:30pm — pick up toddler and spend the rest of the day chasing a tornado.
• ~9:30pm — Kids are in bed (though probably not asleep) so I can finish up anything I didn’t get done during the day if I really need to.

This routine works for me. It works so well, that I think I’m probably about 40% more effective working from home, without the distractions, than I would be working from an office. This is the same routine every day. Sure, I have phone calls, and meetings in there. Sometimes my gym break gets moved up or back an hour. But over all, I start each day the same way. I take the same break in the middle of the day to exercise (clear my mind, get out the extra energy from sitting all morning, etc). And I finish my day the same way — by planning the next. This routine helps me set natural boundaries to the work day so that it doesn’t bleed over into the family time (very easy when your office is just down the hall).

One of the hallmarks of those with ADHD is an ability to be “hyper-focused” on a task when we are really engaged by it. That is a two-edged sword. On the one hand, we get get shit done and it feels almost effortless. On the other hand, we often neglect everything else during that period. By sticking with this routine, even if I’m in a groove, I can stay consistent and steady.

If you don’t think slow and steady progress isn’t powerful, go look at the Grand Canyon, or talk to someone about compound interest.

An organizational system that works for me

My organizational system is on the cutting edge of high-tech productivity tools — I use a blue Pilot G-2 pen, and a Mead graph paper steno notebook.

That’s it.

I’ve tried them all — every todo app or system out there. Things, Hit List, Remember the Milk, Outlook, Google Calendar — all of them. This is the only one that worked for me. Previously, I would try a new todo system and it would be great for a day or two. Then, I’d simply forget to use it. That may sound odd, but it is probably pretty common.

I actually have 2 notebooks. One is for notes, ideas, sketches, etc. The other is strictly for to-dos. I start each day on a new page, and bring anything left-over from the previous day to the top of the list. Then, I fill in the remaining items by priority. This way, when I get started in the morning, everything is ready to go, organized, prioritized, and set.

I certainly don’t trust my memory. To steal a phrase from an old Tom Clancy novel, “if you don’t write it down, it never happened.” This is true in my life. If it isn’t on my list or in my calendar, chances are pretty high that I won’t do it. By now I know myself well enough to accept this and deal with it.

The moral of the story is this — find a system that works for you. It doesn’t have to be perfect, but you have to use it, and it has to work. Then, you can gradually improve it if you want.

An organizational system that you don’t use is worth as much as backups that you don’t test — nothing.

Plan ahead

I mentioned this in the agenda, but this is an important point. A previous boss of mine used to plan the next day before he left the office. Every day, at about 4:45pm, he’d open up his task list in Outlook and move things around. Every Friday, he’d take about 30 minutes and plan out the next week (not as granular, but focusing on big things to accomplish). At the end of every month, he’d take half a day and plan out the next month (more of a goal-setting exercise).

At the time, I didn’t get it. I do now.

By planning his work in this way, he left work at the end of the day, and didn’t feel as though something was left undone. Me, on the other hand, I just changed setting. I went from working at the office to working at the house because I never finished the important things from that day.

This is a great habit, but a tough one, too. I’m still working at this. Some weeks are better than others, but I’m improving.

Regular, vigorous exercise

Late last year, the Atlantic ran an article talking about exercise and those with ADHD. While the article and the research it presented was geared more towards children than adults, the conclusions still apply — physical activity is a necessary component of a holistic ADHD treatment plan.

Regular, vigorous exercise has been shown to ease stress and anxiety, improve executive function (the cognitive functions that allow us to plan, organize, and remember details), and enhance working memory (via WebMD).

I don’t even need to get into the physiological and overall health benefits.

For those people working in an office, the mid-day exercise break is pretty unrealistic. Who has time to go to the gym, exercise, cool down, shower up, and then head back to the office without taking forever? And then what about lunch??

Because of how I structure my routine, this is the most important part of my day. After spending all morning working on stuff, the change in scenery, activity, and pure physical exertion is refreshing. I can’t tell you how many times I’ve left the house after banging my head against the wall on a problem, only to have the solution present itself while I was at the gym or running. There really is something to the notion that you can solve a problem by not thinking about it.

Here is the other great thing about the mid-day exercise break — I don’t suffer from the afternoon energy level drop. Quite the opposite, in fact. My afternoons are just as productive as the mornings. My energy level is high, my stress is low, my thoughts are clear. A great combination.

Moving forward

This routine and set-up isn’t perfect. It is really a work in progress. I’m sure there are a million better ways to structure my day, better tools to use, etc.

Doesn’t matter. I’m focused on this routine. Instead of looking for the magic bullet or the single secret ingredient, I’ll chose to slowly tweak this routine, learning as I go.

I used to shy away from setting big, long-term goals. I’m still a bit hesitant to set them, but I’m more willing. Running the Portland Marathon in October of last year was a huge milestone. A good friend of mine coached me through it. When we started out, my only goal was to “get to the starting line healthy, having completed the training program.” My goal wasn’t to finish the race, it was to finish the training program before the race. I am more proud that I completed the training program than I am about completing the race. I already knew that I could suffer through 26 miles. I wasn’t sure if I could stick to a training plan for 100 days without missing a single mile. Consistent. Relentless.

I’m setting a new race goal. This time, though, I’ll see if I can do it without the external motivation and accountability. After all, that’s all I want — to be self-motivated, self-reliant, consistent and dependable.