Check out this article about studies done at the University of New South Wales about how you can develop stronger impulse control by getting in the habit of using your "wrong" hand more often.

I'm going to try it. I'll let you know how it works.

Ego Depletion/Decision Fatigue: Some Helpful Reading

I've mentioned the concept of decision fatigue on this blog before, and how it relates to ADHD...but as a quick refresher, ego depletion is a new idea based on evidence psychologists are observing about human nature.

Basically, the new evidence seems to suggest that what we might call "willpower" or executive function (i.e., what those of us with ADHD seem to have so much trouble with) is a real, traceable neurological phenomenon related to our brain's metabolism. What's really important about this is that it means that phrases like, "mental energy," or "emotional resources" aren't just cute turns of phrase, they're speaking to a concrete biological reality.

So what depletes our willpower? According to the research, being tired, being hungry, having to make a lot of decisions, having to exercise willpower in the face of impulses, and feeling anxiety or social rejection.

I hope to see someone with real credentials dig into the question of ego depletion in a brain that already has limited executive function, but I don't expect many surprises there. I'd be willing to bet the strength of the ego has a lot to do with a person's dopamine levels. This is the sort of science that's going to blow a lot of holes in our ability to continue being judgmental about people's "character," but you won't see me crying any crocodile tears over that fact.

Anyway...here's some good reading on the subject:

Good ol' Wikipedia

A therapist's rundown about ego depletion and some advice.

Ego Depletion on the "You Are Not So Smart" blog

The Common Ground In ADHD Treatments

I'd like to point you all in the direction of this forum post over at addforums.com.

User bof00 has put together a brief sort of thesis about how, basically, a very specific brain process called BDNF (brain-derived neurotrophic factor) is at the heart of all ADHD treatments. He (she? sorry, bof00!) then cites sources indicating how everything from exercise to omega 3 to meditation to medications have been proven to up the BDNF.

So what is BDNF?

Basically (and this is my half-assed layperson's understanding, mind), BDNF is what makes neuroplasticity happen. Neuroplasticity, of course, being the brain's ability to develop itself into something different, to grow and improve through all stages of life.

Anyway...go read it!

The dangers of the "rewards system"

How many of you folks out there in ADD land have ever tried this trick: you know you have to get X done today, you don't want to do it/know you will procrastinate on it, so you decide that you will give yourself a reward of some kind when you do.

This is a common coping strategy for ADD, and one that I see a lot of people try to employ, including myself. However, I don't know of anyone with ADD who's ever had good luck with it. If you think about it for a minute, it's easy to see why: if our neurology makes us naturally bad at delaying gratification, why would we think that another form of delayed gratification is going to somehow make us be more effective?

I think those of us who try this tactic do so because we've had some well-meaning parent, relative or teacher try to push it on us at some point in our youth. File that under "things that work for normal people," because most neurology-typical people ARE motivated by delayed gratification, so adding to the gratification adds to to the motivation.

Alas, not so for those of us with ADD. However great the gratification in the future, the future is essentially nonexistent for all that our brains can emotionally conceive of it as a reality. We are like the children in the classic experiment who can't wait five minutes to eat the marshmallow, even knowing that we will get a second if we wait it out.

The Now is real for us. The Not Now is something we can only understand as a concept because the mechanism in our brain that should make it feel real is underactive.

So...stop trying to reward yourself later. A far better solution, when you can do it, is to find a way to reward yourself during. How about a piece of chocolate to eat while you work on that boring report? Creature comforts have become a major source of strength for me when it comes to coping with my ADD. Favorite movies on my laptop while I wash the dishes, favorite music playing while I do my writing, snacks while I attend to my neglected e-mail...even something as simple as wearing a favorite shirt or sitting in a favorite chair while performing an unwanted task can have a surprisingly positive effect on my ability to motivate myself to get things done. The same simple, childlike parts of my brain that can't be motivated by something big later can be motivated by something small now.

And always remember...if it doesn't help you, don't bother with it.

Gabor Mate's ADD Approach: My Experience So Far

So, I started this blog about nine months ago. I started writing because I wanted to cover a wide range of topics related to ADD/ADHD, but largely, also, because I was inspired by Gabor Mate's book, Scattered (or Scattered Minds, depending on whether you buy the US or Canadian version). You can read my initial post about it here.

So how's it working out for me?

First and foremost...I feel better about myself. I've been taking the time to dissect my life experiences, especially my formative, childhood impressions and see how it's affected my sense of myself, my most deep-seated anxieties. I'm beginning to feel my ADHD as those anxieties, not just as some random tweaky brain I can't figure out or control.

It's not a fast process. I mean, the emotional progress can come in leaps and bounds, but how it actually informs my ADHD is something that only changes gradually. Today, I'm feeling like something big has happened in that arena: some last shell of a major anxiety construction of my own fell away and I have this...I don't know, this strength from somewhere that allows me to push through. A confidence to self-actualize. I'm guessing this is what the executive function feels like.

I'm still trying to decide how much of my personal stuff I really want to post here...bear with me while I decide, and I apologize if this post is a bit vague. I want to do what's most helpful to my readers, not use this as a personal therapy blog.

The Double ADD Relationship: Why It Can Work

I have ADD, and so does my husband.

What I have found this means for us is that none of the expert advice or standard conversations about ADD and relationships apply to us. All the books, articles, forum chats, stories, rants and related tales from couple's counseling I've ever seen deal mostly with the challenges of an ADD partner and a non-ADD partner figuring out how to reconcile their differences and come to terms with the challenges of the relationship. Most commonly, it seems, the challenges of a relationship for someone with ADD come from the basic caring=instant results misunderstanding we all know too well...you know, where someone close to you assumes that if you actually CARED about their feelings and circumstances, you'd be able to keep a job/get organized/remember birthdays/focus during a conversation, etc.

ADHD Medication: Things to Consider

Since I write a blog that's largely concerned with natural coping mechanisms for ADD you, might think I'm opposed to medication. I'm not, actually, but I do have some pretty strong feelings on the subject nonetheless. I thought I should write a post to clarify, and to use as a point of reference, later.

In truth, I believe that medication can be a very fine thing and an important part of many people's coping and recovery. I myself took two kinds of medication at different points in my teenage and young adult years; Ritalin for a couple years in high school and Strattera for a couple years in college. In addition to the extra boost of help these drugs gave me during critical times in my life, they taught me an important lesson about the differences between my brain and those of most people and what it could feel like to live with less disability. A lot of the positive effects of these drugs became permanent as I strove to achieve the same level of performance without them that I had with them.

Coping With Procrastrination

As a follow-up to my earlier post about the causes of procrastination, I'd like to talk a little bit about some effective coping mechanisms I've discovered. Lately, I've found it immeasurably useful to deal with procrastination by dissecting it. In order to do this, I ask the following questions:

1. What am I avoiding right now?

The first question is usually pretty easy to answer; when you're avoiding something, it's usually on your mind, poking constantly at the back of your thoughts and causing you stress. Sometimes, however, that stress can be great enough that you simply can't make yourself think about it enough to address the avoidance. For this reason, it's a good idea to attempt this exercise at a time when you're feeling relaxed or happy. Also, I find it very effective to sit down and make a list of the things I'm avoiding and worrying about; getting them out of my head and onto paper transforms them from a stress-inducing spectre into something manageable.

Fostering Healthy Romantic Relationships

This is an article I wrote a couple years ago about fostering healthy relationships with someone who's got ADD. I've had a few people tell me that they've found it helpful, so I've decided to re-post here. This is a list of tips and tricks for non-ADHD partners. I intend, at some point, to write a follow-up list of tips and tricks for the ADHD partners.

Know how their brain works. The first and most important thing you, as a non-ADD partner (NAP) need to understand about your ADD loved one (ALO), is that her brain works differently than yours, because it's lacking a lot of electrical signals necessary to behave as responsibly as she'd like to. Therefore, a lot of assumptions that you might make about the motivations behind her actions aren't necessarily going to be accurate.

For example, it's quite common for an ALO to forget that she's supposed to meet her NAP at a certain time for a date, only to get caught up doing something else and lose track of time. The NAP will often assume that this means the ALO didn't care enough to make the appointment, but in truth, this is almost never the case. In general, it's easy for NAPs to assume that ALOs just "aren't trying hard enough," but usually, we're trying as hard as we can.

Expect apologies, but accept them. If your feelings have been hurt, or if you've been inconvenienced in some other way by your ALO's ADD-related behavior, you should expect an apology from her - after all, she needs to learn to take responsibility for her symptoms, even if they aren't her "fault." But if she gives you a genuine apology, accept it.

Expect improvement, not perfection. Many NAPs will get frustrated with a certain behavior in their ALO, and expect that telling her once should be enough to solve the problem completely, and that if it isn't, she didn't get the message. This is not the case - changing our behaviors takes a great deal of time and effort, so if you see any steady improvement at all, even very small improvement, you can be certain that your ALO is doing her absolute best to do what's fair to you.

Positive reinforcement is nearly always better. Because we are driven so strongly be our emotions, people with ADD are often extremely sensitive to criticism. Moreover, the negative feelings we associate with that criticism will often cause us to avoid the problem in question and thus, to avoid solving it.

On the other hand, positive reinforcement has the opposite effect - if we're complimented on our improvement, we will want to continue facing down the problem and improving. Despite how it may seem at times, it's actually quite important to us to please our loved ones.

Know the right way to express your disappointment. Sometimes, you have a right to get upset, but always remember that any harsh words or raised voices are going to have twice the effect on your ALO that they would on anyone else. For this reason, choose your reaction and your words very carefully.

I recommend that you avoid speaking out of anger, ever. When you're feeling angry, the best place for you to be is far away from your ALO. Vent to a friend, punch a wall, engage in some primal scream therapy and say all the angry and hurtful things somewhere where she won't hear them. Then, once you are able, return to her and be honest about your feelings. There's a big, big difference between calmly saying, "This made me very angry today, enough that I was screaming insulting things about you," and actually screaming those insulting things at her, and the former will make her understand your feelings and the importance of taking them seriously without doing irreversible damage.

Remember that the good and bad are connected. For whatever reason, people with ADD often share many extremely positive qualities such as creativity, charm, and a kind, generous character. Chances are, these are some of the things that made you fall in love with your ALO in the first place. Whenever you feel frustrated with one of the difficult aspects of her ADD, remember that the good things about her are there are for the same reason that many of the bad ones are.

Never forget to take your turn. As the NAP, chances are that you will often feel that you're "taking care" of your partner, in much the same way that partners of people with physical disabilities do. Always be proud of yourself for this, and for the fact that you love your ALO enough to have patience and to help her get a handle on her issues for both of your sakes.

But also, don't forget that your ALO has a responsibility to you. Tell her how it's important that she take care of you sometimes, teach her how to do this, and don't be afraid to tell her when you need this kind of treatment. She will most likely respond with enthusiasm.

Procrastination

Image courtesy of Daily Pictures.

The above is a somewhat famous product of that wonderful internet meme, the demotivational poster. As you can see (provided you're not reading this post months or years after the image link breaks), it reads, "Procrastination: Hard work often pays off after time, but laziness always pays off now."

There is, of course, quite a lot of obvious truth in that cynical statement. Still, most of us learn at a young age that what is best for the present moment is not always what is best for the future moment, and that future moments have a nasty habit of turning into new present moments. We also learn that many of those new present moments can, with the help of hard work we've done in the past, yield some very excellent results that don't come of seeking quick rewards. So we figure out how to forego instant gratification for the sake of the sake of long-term security in our lives and the pursuit of complex ambitions with big and/or sustained payoffs.

For those of us with ADD, however, that learning process never quite seems to gel. Sure, everybody struggles with procrastination and discipline throughout their lives, but for us, these troubles are a constant, oppressive companion.

Study of neurology has, in recent years, finally started to confirm what so many of us have felt in our hearts but often never dared say; it really is harder for us. Certain areas in the prefrontal cortex of the brain never activate for us the way they do for others, areas devoted to impulse suppression that should be assisting us in overcoming our procrastination. When people say, "mind over matter," this may very well be the part of the mind they're talking about.

So we get through life as well as we can without it. Those of us that can motivate ourselves enough to be high-functioning usually do it through a complex system of guilt and self-recrimination mechanisms, fueled by the memory of childhood shaming by family and teachers. We don't have the power to overcome our impulses, so we manipulate them with negative emotion, just as adults learned to do with us in childhood. Those of us who have found some level of reprieve through medication know that something magical happens when a pill works for you; something switches on that was never there before, a part of the brain that we've always been aware should be there, but isn't.

All of this should seem to point pretty readily to the conclusion that the issue for us is a pure hiccup in neurological development, an immutable difference in our brain biology. And yet...I don't really feel like the fundamental reasons for my procrastination are all that different from those of most other people.

The language we use to talk about procrastination tends to be unquestioningly harsh and judgmental. We shame people for "laziness" and view a lack of ability to self-motivate, organize, and place the nose to the grindstone as a moral failure, a form of selfishness.

I think this is why, when ADD research comes along and seems to say, "Hey, it's not their fault, their brains don't work," it often triggers a jealous response in people. After all, why should we get a free pass when no one else does? You can often find a similar judgement response to other mental health diagnoses, or even to people with limiting physical ailments.

However, there is a potential paradigm shift occurring in our understanding of "laziness," one that takes a hard look at the simplistic, moralized view of these issues and looks at the psychological roots of procrastination.

One book I highly recommend along these lines is Jane Burka and Lenora Yuen's book, "Procrastination: Why You Do It, And What To Do About It NOW." The essential thesis of this book is that procrastination is caused by fear, sometimes deep-seated insecurities, connected to the action at hand. Fear of failure, essentially, prevents you from trying because hey, if you don't put your best effort into life (or some area of life), at least you can hang on to the idea that if you ever did really try, you'd succeed.

I honestly don't think the psychological roots of ADD procrastination are any different from that. Certainly, there is a biological component; for most people, these fears haven't catalyzed into the same severity of neurological limitations. Those prefrontal brain parts (as I've learned from Dr. Mate) actually filter and control emotional impulses, making them easier to overcome through willpower.

All this means is that if you have ADD, it's all the more important that you deal with the root emotional causes of your avoidance issues. And yet, all too often, ADHD treatment starts and ends with medication, shrugging its shoulders and pointing to the reality of altered brain chemistry as if it were an impassable obstacle.

I know from my own experience that with the right approach, you can greatly lessen the impulse to procrastinate. It's all a matter of convincing yourself that really, those short term gains aren't the best you can ever hope for.

Meditation for ADHD: A Brief Introduction

Of all the natural coping methods I commonly see recommended for those with ADD, one that, to me, doesn't get nearly enough props is meditation.

I don't know why this is. Perhaps it's because it's just too New Age-y for some folks. Maybe it's because those acquainted with the issues of ADD find the idea of prescribing intense concentration to treat focus problems as lofty, perhaps even laughably so.

Whatever difficulties can come in learning to meditate (I'll get to those in a moment), I still think it's a shame not to try. The benefits of meditation to the ADD mind are profound in both a practical and emotional sense. First and foremost, it helps with hyperactivity, teaching one the art of stillness and calm. It's also a highly comforting balm to the emotional distress we so often experience, while creating a mental state excellent for gaining insight and unraveling bad habits. And of course, it helps with focus.

I myself learned to meditate via a hypnotist (hypnotism and meditation are essentially the same things; the differences between them split hairs along the lines of how the trance states are used, but that's really up to the user either way). He was actually an entertainer, and with trademark ADHD "look at me!"-ism, I volunteered to be a "subject" for his stage show. I found the experience of hypnosis so profound, I bought some of his CDs and started to learn self-hypnosis. The CDs contained ambient electronic music as well as progressive relaxation hypnotic inductions and instructions, including guided visualizations and behavior-modification exercises. Pretty basic stuff.

Chances are, I wouldn't have been able to learn the discipline if I'd tried to start from scratch, no music, no direction, just me sitting down, closing my eyes, and trying it. I needed the voice on the CD to give me direction and keep me focused until I'd been doing it for quite some time on my own. But that's what worked for me. For many people, visual stimulus is required to get into a meditative state, or some kind of meditative physical activity, like yoga, or a repetitive action. Things like drawing, getting lost in music, light housework, gardening, working with your hands, can all be good ways to get into the mindset.

Some good resources:

Pandora Internet Radio. Design an ambient music station of your own to help you with meditation. (I use "Kitaro" as my foundation, personally.)

Frederick Winters. This is the guy I learned hypnosis from.

Self-Hypnotism. This is an instructional article I wrote for eHow.com.

Illuminescence on YouTube. This user creates videos with hypnotic visualization and binaural beat music to assist in achieving a trance state. Just sit somewhere comfortable and watch and listen, preferably in the dark.