I was 30 when the fear of failure grew large enough to overcome the fear of certainty. It was clear to me that I was struggling with everyday life, but knowing why was scary. Was I lazy and unambitious?
Would you want to put yourself in a position where the definitive answer to that question was (maybe) yes?
That is the choice I was facing at 30. I was about to start a job with a company I cared about. It was a challenging, interesting role that would let me flex my diverse skills. I was so scared of failing that I took the first step towards finding answers for questions that had been tumbling around my mind for 15 years. At 8pm the evening before my first day, I walked into a late-night general practice and came out with a referral for a psychiatrist.
After that first step, each subsequent step became simpler. Over the next few months my psychiatrist and I explored the evidence. Discussions about my relationships, family, finances and career formed one set of data. Interviews with my parents became another. We examined my academic record, from school report cards through to university transcripts.
The answer to the question causing me existential despair for years was laughably clear to my psychiatrist (he’s a delightful man, really). I wasn’t unmotivated, disorganised, absent-minded, slow and perpetually late. Well, I was, just not inherently. I have ADHD.
A More Complete Answer
With a few exceptions, this is my life. I procrastinate on anything requiring an unappealing first step. Inefficiency and lateness plague my appointments, meetings, projects and chores, if they aren’t already abandoned. I’m highly susceptible to making short-sighted health and financial choices. I get overwhelmed by noise, touch, smell and temperature.
I mentioned some exceptions. These invariably align with past experiences that terrify me enough to overcome situations where others with ADHD get stuck. Being treated poorly by an ex motivates me to avoid inflicting similar pain on others. Taking microbiology subjects at university has given cleanliness and hygiene a sense of urgency. Being hyper-aware of how dangerous the road can be is stimulating enough to make me an excellent driver.
It would be unfair not to say that there are some benefits to having ADHD. I attribute much of my creativity and academic achievement to having ADHD. There’s no room for intellectual or creative stagnation when everything is intriguing and boredom isn’t an option.
I’m also cool-headed and collected in emergencies. My theory about this two-pronged: a) I’ve probably daydreamed my response already, and b) my brain has capacity for the stimulants that bodies produce in crises.
At 30, when my psychiatrist and I totalled up the negative influences, neutralising factors and benefits of ADHD, it was fair to say that, not only did I have ADHD, I wasn’t coping with it. I was scared, anxious, frustrated and doubted myself. None of those feelings are characteristics of ADHD; they’re side-effects of unmanaged ADHD.
Everything I’ve written up to this point is there so you can identify our commonalities. Are you like me? Then maybe some part of the ADHD management framework I’ve gradually assembled can be added to yours.
The major components of my personal framework for managing ADHD are four pillars and one ‘insurance policy’.
The first four may seem obvious requirements for life in general, but there are specific reasons for building up each of these pillars first. Lastly, for me, medication is currently a vital protective measure for my pillars. Having the entire framework gives me the support that’s needed for further optimisations.
Regular exercise is a crucial and central part of managing my symptoms. It doesn’t solve all my problems on its own, but it does form one pillar, which reinforces other structures.
The best part about exercise, though, is that it has both immediate and long-lasting mental, physical and cognitive effects.
Going for a run, climb, hike or yoga class (my personal preferences for exercise; yours should be whatever suits you) gives me immediate relief from the pressures of ADHD.
- Doing anything productive means good brain chemicals
- Exercising itself means more good stuff being produced in my mind
- The physical challenge gives me mental freedom for deeper thought
Most people are well-aware of the long-term benefits of exercise, such as better cardiac health, weight and strength management, and lessened cognitive decline. Besides those more obvious ones, exercise helps my ADHD brain in some specific ways.
- Planning ability: I have to take into account weather, clothing, eating times, fitness level and personal safety when I plan to go for a run or hiking. And then check for clashes with personal, social or professional commitments. Yoga classes at my gym need to be booked 5–7 days ahead of time. Going climbing requires a friend to be available. My love of these particular activities encourages me to be better at planning, which transfers to other areas of my life.
- Focus: running, hiking, climbing and yoga each spur the development of better focusing abilities in different ways. Running and hiking require pacing and persistence. Climbing requires careful attention to positioning and timing. Yoga requires single-mindedness and intention.
- Goal setting: the direction of improvement is often clear when it comes to exercise. Run or hike faster and further; climb harder. Yoga is more difficult to quantify, but progress and success in running, hiking and climbing are relatively easy to measure. This inspires goal setting in a low-risk environment. It’s not the end of the world if I didn’t beat my goal time — the journey still mattered. I’ve learned a lot about success metrics, estimating progress, setting milestones and deciding key performance indicators from making exercise-related goals.
I get instant gratification and automatic (free!) long-term benefits from exercise. Exercise both supports other parts of my framework and helps me out with day-to-day life.
While this study investigates exercise interventions for children with ADHD, it has a good overview of the topic if you want to read more.
To combat the ADHD tendencies that influence me toward avoiding exercise, I developed the following tactics:
- Finding my favourites. I’ve tried many different forms of exercise. Most were boring (regular gym), unpleasant (team sports), wildly impractical (caving, surfing) or too expensive (SCUBA). I wouldn’t have found activities I enjoyed without knowing what didn’t work for me. Once I knew what I liked, the enjoyment motivated me to come back again and again.
- Active and positive pre-commitment. Every obstacle between you and exercising is one you might trip over. Your motivation might not be enough to get you there alone. Just do it is an awful motto for people with ADHD. I like to smooth the way as much as possible by removing obstacles. I pack my climbing gear or set aside my running clothes ahead of time. I charge my watch and phone earlier in the day or the night before. I leave my car parked on the street so I don’t have to get it out of the garage. I pre-pack snacks, sunscreen, water and anything else that contributes to a positive exercise experience.
- Appeals to vanity. If nothing else works, I remind myself exercise is the best way to look good naked.
Tactics I avoid:
- Punishment. This just doesn’t work, at all. Creating a negative association with something is the fastest way to send me in the opposite direction (more about avoidance and ADHD). If it’s someone else being disappointed, upset or angry on my behalf, the effect is even stronger.
- Bribery. Time-blindness renders bribery pointless. Like a lot of people with ADHD, I more-or-less experience time as now and later. Later is too indefinably far away for bribes to be motivating and taking a bribe now means I can go back to procrastinating.
Getting regular, high-quality sleep that’s sufficient is really, REALLY, important. I cannot emphasise this enough. Sleeping well is as critical a pillar in my ADHD framework as exercise is, maybe more.
For me, it’s more effective to counteract the ADHD things I do before bed than it is to add optimisations like sleeping masks or supplements. No amount of sleep aids, lighting, fragrance, or avoiding alcohol, caffeine or sugar makes a difference if I’m not actually in bed. The biggest obstacle to sleeping well is delaying my bed time because there are more interesting things to do than going to bed!
Getting over that hurdle is hard. I’m at my least rational when I’m tired; it’s difficult for me to make choices and I’m more likely to put off decisions. Like starting on essential pre-sleep actions: taking out contact lenses, charging my phone, brushing my teeth.
I haven’t found a totally reliable method of getting to bed, but I do have a lot of success combining and cycling through the following tactics:
- Exercising in the morning gives me physical cues that I’m tired and need to go to bed
- Wearing a watch keeps me aware of the current time
- Completing my pre-sleep activities (brushing teeth etc) before I’m tired
- Using my bed for sleeping (not TV, reading books or using a laptop)
- Wearing a sleep tracker — I like seeing the data in the morning
- Having nice things in my bed (partner, clean sheets, comfy pillow, cat)
The biggest positive impact on my sleep quality has been having a partner with a rock-solid sleeping routine. He goes to bed and wakes up at virtually the same time every day. The waking up part of his routine makes a particularly big difference to my day. If I’m left to my own devices, I’ll make up for my late bed times by sleeping in.
I was forced to recognise the importance of waking up at a regular time when my partner went on a 10-day trip while I stayed home. The lack of cues to wake up meant by day 4 I was going to bed at 3am instead of 10pm (and living on cake, but that’s another story). My getting-to-bed tactics couldn’t counteract the effect of sleeping later in the morning.
If I can get to bed before I’m over-tired and then wake up on a regular schedule, that’s 95% of the battle won. The other 5% of effort required for good sleep comes from a few straightforward techniques:
- Sleep in the dark. Block out light from windows, screens, charging devices — everything you can. Or if it’s comfortable, wear a sleep mask.
- Keep it cool and fresh. I get extra fidgety when I’m too warm and it affects my sleep quality. I have a thin cotton blanket and sleep with the window open through winter. Summer here is challenging, even with air conditioning.
- Minimise engaging noises. This is likely to be different for other people, but I can’t fall asleep if there are audible distractions. TV shows, talkback radio, neighbours chatting — I’m actively not interested in these so they become annoying focus points. If I can’t control these, I shut windows, wear noise-cancelling headphones or listen to nature noises.
- Exercise regularly. Besides all the other good reasons to exercise that I’ve already mentioned, it helps me sleep. I try not to exercise too close to bedtime, though, because it makes me more alert in the short term. The physical tiredness keeps me conscious of the need to rest, but regular exercise conditions our bodies to sleep well too.
Besides exercise and sleep, water is another key pillar of my personal ADHD management framework. The benefits of staying hydrated are well understood. Luckily, drinking water is something my body has a built-in reminder for. I get thirsty, and it’s difficult to ignore or procrastinate about.
Getting a drink is also an easy way to take a break from doing something physically or cognitively demanding. So it’s generally simpler to get enough water than it is to get enough sleep or exercise. If you want more specifics on hydrating better, read this article.
All that said, there are a few reasons why staying hydrated (with water) is important for me:
- I get irrational when I’m dehydrated, which exacerbates the symptoms of ADHD
- Dehydration impairs concentration, which is a scarce enough resource as it is
- It’s easy to get my hydration needs from food and calorie-containing drinks, leading to accidental over-eating
I love food, and having ADHD makes my relationship with food complicated. Obesity is a problem for people with ADHD. Food is a readily available source of instant gratification, but one can’t just cut out food. Unlike other addictive substances (nicotine, for example) or activities (nail biting perhaps), it’s not possible to quit food.
I’m a pretty stubborn person and quite capable of removing problems (such the cognitive dissonance eating fish was causing me) from my life. I can do all-or-nothing mode, no problem. But I’m not good at implementing gradual change, like eating healthier foods or cooking at home more often. Those require lots of consistently good choices.
An extra complication for me is that I’m a relatively small person. I only need to consume about 1300–1400 calories a day (roughly 5400–5800 kj). Setting aside the compensatory effect of exercise, that’s not a lot of room for error when it comes to maintaining a healthy weight.
So managing what I eat is challenging, but it’s the fourth pillar of my framework. Exercise, sleep and being hydrated don’t get you very far if you’re cranky, lethargic, overweight or just really fucking hungry.
I know that to eat well I need access to:
- low calorie snacks: foods I can eat without needing to pay much attention to quantity. Vegetables, popcorn, yoghurt and rice cakes are easy to snack on while I’m working. If I don’t have these available, I’m at risk of mindlessly downing higher calorie foods or eating a larger meal than I should later in the day.
- small, high nutrient snacks: super tasty foods that are good for me but limit over-eating. Fruit, nuts, whole-grain toast, eggs and oats work well for me. These are satisfying and tend to come in appropriate portion sizes.
- planned, diverse meals: preparing meals ahead of time reduces the likelihood of making a low quality choice when I’m hungry. Adding in plenty of variety gives me choices when I’m being picky.
Like exercise, figuring out what foods I like has been really helpful.
Imagine living in a house without a roof or walls, just a frame. You’re exposed to the whims of the weather. Animals small and large wander in and out. Strangers intrude on you any time they like. Kids put graffiti on your furniture. Your possessions don’t last as long as they should.
Starting ADHD medication was like giving my mind a roof and four walls. There was no constant drizzle of procrastination. No more distracting thoughts zooming in and out. My intentions sat there in front of me, undecayed. Suddenly, I was in control of how I interacted with the world.
Medication might not be the right choice for you, but, either way, be sure you’re making an informed choice. Keep learning from other people’s experiences; talk to your doctor or psychiatrist; give different medications a chance.
If you’re confident that you’ve got the core elements of your personal ADHD framework sorted out, read on for a brief list of potential tweaks. Alternatively, if you don’t have it together and you need a quick win, the following list is also for you.
- Noise-cancelling headphones: clean, predictable silence or music makes concentrating vastly simpler. I can sit here and write this while a TV show plays in another room thanks to not being able to notice it at all.
- Ad-free services and ad-blockers: I loathe hearing and seeing adverts. They’re designed for maximum distraction and derail me instantly. Do whatever you can to not see or hear them. I pay for media providers that don’t have ads. All my browsers have ad-blockers installed.
- Minimal notifications: turning off all but critical notifications has streamlined my life a lot. I used to waste a ton of time whenever I got a notification. Reading it, forgetting what I was working on, getting side-tracked and so on. Reducing notifications required investing time to dig through various settings and enable filters. I also went to the extent of uninstalling most social media apps from my phone. This is a fantastic guide to configuring an iPhone for productivity.
- Specialised tools: as an impulsive spender, this can be problematic, but having the right tool for the job smoothes the way. Low friction software means I’m less likely to get hung up on not knowing how to do something or distracted by non-essential features. I like Hemingway for writing, Reeder for reading, the default macOS apps for calendar and mail, and Spotify for music.
Thank you and tl;dr
Thank you for reading all the way down to this point. I know this is a lot to think about. It took me awhile to sort through my thoughts and get them into words.
If you’re looking for the ASAP win:
TL;DR — knowing I have ADHD empowered me to deliberately build a framework of supportive exercise, sleep, hydration and eating habits. Adding medication protects my framework of helpful practices from myself.