How Do You Get Going? Working with ADHD

Screens for ADHD measure five clusters of symptoms: 

  • organizing and activation for work
  • sustaining attention and concentration
  • sustaining energy and effort
  • managing affective interference (emotions that get in the way)
  • utilizing working memory and accessing recall.
The DSM checklist assumes that ADHD is a diagnosis for children. If you didn't have it as a child, you don't have it now.

Well, okay. I am not qualified to quibble with the American Psychiatric Association about how many angels dance on the head of a pin and when they showed up for the dance. But the problem of diagnosis is this: I can't remember which of their criteria I demonstrated in my childhood. And my mother certainly never noticed any struggles that her brilliant and perfect daughter may have experienced in the early 1960s. I mean, she didn't even notice suicidal depression...

So what do I make of that DSM assumption?

CHADD - Children and Adults with Attention-Deficit/Hyperactivity Disorder has this to say about diagnosing adults:

Although some ADHD symptoms are evident since early childhood, some individuals may not experience significant problems until later in life. Some very bright and talented individuals, for example, are able to compensate for their ADHD symptoms and do not experience significant problems until high school, college or in pursuit of their career. In other cases, parents may have provided a highly protective, structured and supportive environment, minimizing the impact of ADHD symptoms until the individual has begun to live independently as a young adult.

Okay, Mama would buy that explanation, since she would say that I am very bright and talented. And she was right.

Now I have been diagnosed, notwithstanding that my interest in schoolwork hid my difficulties with attention and activation, and I was (usually) able to find workarounds for those difficulties. I am taking medication, which is helping immensely.

But this is not my first rodeo. I know that medication helps. It's like a crutch. Crutches really help people who have a problem with a leg. But they still have to use that leg.

So. How do we use that feeble leg?

Working around Activation Issues

How do people with ADHD start?

It's a bizarre kind of issue, embarrassing actually. Here I am, all my work tools lined up, great idea in hand, some measure of enthusiasm even.

And I Just. Cannot. Start.


How do I trick my weird little brain into "go" mode?

My go-to strategy used to come from Mark Twain's observation:

Eat a frog for breakfast and nothing worse will happen to you the rest of the day. 

Okay, I know that's bizarre. But my book has a whole chapter devoted to the meaning of bizarre. Bizarre works for me.

The idea used to be to pick the thing on my to-do list that most resembled a frog, so that eating it for breakfast would constitute the worse thing that would happen to me that day. Everything else that followed would seem easy.

For example: call my Costa Rican internet provider to find out why I keep getting kicked off my connection. It took two weeks to get around to this phone call, out of a six week stay.

That's a frog.

So one day, I did it first.

Only, I didn't do it first. It's a really effective strategy for neurotypicals, and I stand by it for neurotypicals. But it wasn't actually what I was doing.

My frog was the second course of the day.

Once I analyzed my behavior, I realized I was following a different aphorism:

Eat dessert first

Right before I made that call to the internet provider, I did something else first, a little task that I enjoyed and that gave me a sense of competence.

Just one bite. Don't get distracted. That's another ADHD hazard that I'll discuss next post.

That gave me a shot of dopamine, the feel-good neurotransmitter. I rewarded myself before I made that phone call.

In other words, make your brain your friend. Your ADHD brain. Not everybody else's brain. That first bite of pie jump starts the brain that is stuck.

The website for Advanced Psychiatry Associates, located in California, has a raft of suggestions. One of them reminds me of my strategy for getting started:

Get organized

That may seem a bit of a stretch until you break it down. I mean, if you were organized, you wouldn't have ADHD, right? But it's not the organization that helps you get started. It's the little task of organizing something that does the trick.

My version: Make a list.

That's all. Just make the list.

I make a list for the week, not the day. That way I can reward myself for whatever I manage to accomplish, which gives me that dopamine hit that moves me to another item on the list. 

If I don't get the list done in a week, well, I make next week's list! The list itself is for me that one bite of pie. As soon as I make it, I can get started on one item on it.

Yeah, this isn't the perfect solution. Sometimes one particular item moves from one week's list to the next until it becomes a moot point. But it helps. It helps me.

What helps you? Add your tricks to the comments.

This post has addressed the first cluster of ADHD symptoms, one of my top difficulties - activation. Next post will move on to the classic symptom - it's in the name, after all - attention deficits.

photo of pie from

No comments:

Post a Comment

Popular Posts