#### [[Attention deficit hyperactivity disorder]] --- # What Is ADHD > Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children. ADHD also affects many adults. Symptoms of ADHD include inattention (not being able to keep focus), hyperactivity (excess movement that is not fitting to the setting) and impulsivity (hasty acts that occur in the moment without thought). > <br> > -- *American Psychiatric Association* # What Are The Types ADHD is diagnosed as one of three types: - *Inattentive* - *Hyperactive*/*Impulsive* - or *Combined* A diagnosis is based on the symptoms that have occurred over the past six months.^[https://www.psychiatry.org/patients-families/adhd/what-is-adhd] In most cases, ADHD is best treated with a combination of behavior therapy and medication.^[https://www.cdc.gov/ncbddd/adhd/facts.html] # Symptoms & Presentations - Impulsiveness - [[The search for novelty in ADHD will cause one to flit from interest to interest inadvertently becoming a generalist]] - Object Impermanence - [[Object impermanence in ADHD affects preference for top level structures]] - Hyper/Scatter Focus & Time Blindness - [[ADHD hyperfocus is a double edged sword of both deep work and avoidance]] - [[ADHD scatter focus coupled with context switch friction make it difficult for ADHD brains to transition away from roadblocked tasks to continue being productive]] - Executive Dysfunction - [[A well established environment makes reliance on self control discipline and willpower unnecessary]] - [[Well defined tasks negate the need for the use of the limited supply of will power]] - [[With poor executive function even activities you would like to do become difficult to approach]] - [[Decision making is wearying and takes resources from other domains of life]] ^da67ce - [[Context Switching is painful for ADHD brains]] - Emotional Regulation - [[Avoidant Attachment]] - [[Stoicism doesn't work with ADHD]] - *Rejection Sensitive Dysphoria* - [[Rejection Sensitive Dysphoria causes people with ADHD to become people pleasers]] - Poor Working Memory - [[The impact of ADHD on working memory can be combatted with spaced repetition and active recall]] - Inattention - [[ADHD Brains are able to observe and interact with several subconsciouss processes simultaniously]] - [[People with ADHD do not have a lack of attention only an issue regulating attention]] - [[Neurodivergent brains like those with ADHD mask to fit in better amongst neurotypicals but this is exhausting]] - Perseveration - [[Perseveration similarly to executive dysfunction context switching causes abnormal and intense fixations to the detriment of the individual]] - Sensory Processing Issues - [[Sensory overload such as loud and competing audio input can cause irrational anger within the neurodivergent]] - [[When the visual stimuli in conversation is distracting, ADHD brains may exhibit anti-social behaviors in order to be exactly the opposite]] - Delayed Sleep Phase #✅️/🟩️ - Revenge Sleep Procrastination #✅️/🟩️ - Postural Sway #✅️/🟩️ # Comorbidities & Related Conditions - Autism Spectrum Disorder (ASD) - Obsessive Compulsive Disorder (OCD) # ADHD Handbook For [[Neurotypical]]'s > **Caveat** -- "This is how others might work best with me, some parts of this may be useful to you, but this is not prescriptive, supported by research, and is solely based on personal observation and preference" - *Impulsiveness* - **What It Looks Like:** - I may do impulsive things such as beginning work without getting full and clear directions - Say things without thinking them through - Fire off emails, incomplete work, and prematurely take action - **How To Help/Handle:** - If you can catch me before I are about to undertake an impulsive action, gently suggest an alternative, I am receptive and often will think from your perspective if presented with it. - If I make a mistake, please don't make a mountain out of a molehill. ^3b2e81 - **PLEASE** do not chide even jokingly in public - If I must be disciplined or I am in trouble, a calm tone and expression of displeasure is already overwhelming and will have more than the intended effect thanks to [[Rejection Sensitive Dysphoria causes people with ADHD to become people pleasers|RSD]] - Often just informing me of the problem/error/issue is sufficient for me to kick myself for my mistake. - I endeavor to not repeat mistakes but if you're bringing one to my attention a soft voice is already deafening to me emotionally. - If its appropriate ending on a light tone or even a joke to smooth over the situation and so I: - can see you are not lastingly upset - don't anxiously overthink and over analyze how you're feeling about us - feel like I can move past the incident with less "sting" - *Object Permanence* - **What It Looks Like:** - Horrible at remembering to reach out to others and maintain social relationships - I literally "forget" to reach out, I forget about people and forget to maintain my relationships. - I lose things, or forget about them. This become misplaced - **How To Help/Handle:** - Use some sort of calendar or reminder system to reach out to friends, remember social occasions, and birthdays - Push for a goal to work towards "one double date couples night per month" - this makes it more tangible to reach out socially - Because I have object permanence issues, "out of sight out of mind" - I need to see things visually, spread out, at a top level to more effectively work with them - If things are buried in folders inside of folders, or put away (vegetables in the crisper drawer) - *Hyper/Scatter Focus & Time Blindness* - **What It Looks Like:** - Hyper focus is a double edge sword that can allow me to work 9 hours straight - It means I forget to eat, take breaks, and even postpone going to the bathroom until the need is too great to avoid - It means if called to context switch, and swiftly pivot to another task or activity - It is downright <u>painful</u> - I will struggle immensely to shift gears and often require dedicated time to disengage with one task to begin diving into another - I get lost in the work and often miss the forest for the trees - Scatter focus is when I cant focus hard enough to do something I should be - The attention is scattered, and I cant collect it to focus on something specific - Time Blindness is when I lose track of time especially when hyperfocused on something - "Oh shoot, look its already lunch time!" - **How To Help/Handle:** - Hyper focus is a lot like a cannon, incredibly powerful but hard to aim - Channel the hyperfocus and use it to your advantage. - Provide solid blocks of protected time to deep dive into a task - Minimize unnecessary interruptions (meetings that could have been emails) - Support and encourage [[Asynchronous Communication]] - If a need to separate it may be necessary to "PULL" me out - something as simple as "Hey, go for a walk. Yes, NOW. Go." - or something that puts the focus on YOU, "Let get lunch **I'M** hungry" - for couples this is very effective, I will hardly ever cook for myself but if my partner is hungry and i'm making dinner, the external motivating factor makes it easier to undertake the activity - Scatter focus is sometimes harder to handle than hyper focus. A comparison of aiming a fire house juxtaposed to a hose with 100 spouts and you need to gather them together and THEN aim - A helpful strategy is to help collect and gather my attentions. - Lay out some basic "next steps" sometimes it's like just being in a forest and losing the path (productivity) - what could help is simply pointing out where the path is again and the first few steps on that new path. - Time Blindness is often coupled with hyper focus, I lose track of time and am often a poor manager of it - What can help is outsourcing this work to software. Alarms, calendars, annoying in your face reminders - If i'm late for a meeting for some reason due to the alert/reminder coming through - please re-read [[#^3b2e81|How to help/handle Impulsiveness]] - *Executive Dysfunction* - **What It Looks Like:** - Executive dysfunction is a very pervasive aspect of ADHD that effects the ability to regulate our will power and self discipline - Unable to begin unfamiliar & large tasks - Difficulty beginning tasks/activities even ones I desire and want to do - Hard to begin tasks I do not like doing (ADHD brains chase the dopamine) - I do and pursue things I enjoy often neglecting my responsibilities and obligations - I find it hard to make decisions especially when confronted with a large amount of choices to pick from - **How To Help/Handle:** - Executive dysfunction is very difficult to handle but some helpful strategies can be - to break down larger tasks into smaller pieces and then slowly feeding them linearly to me - sometimes just breaking a large task into a pile of smaller tasks is just as bad or worse - because I may then get anxiety just looking a pile the same size but now the view that there is a larger number of tasks. - or having those broken down tasks laid out on a path with a plain or methodology to follow for their completion - The idea behind this is avoiding cognitive load, friction, and paralysis of choice [[#^da67ce]] - All the assistance to be provided towards organizing the tasks/work into a way that makes it easier to bite off into management chunks as well as reducing the volume of choices that need to be made - A very poignant issue ADHD brains have is doing things that are not interesting. - At first glance kind of a shallow and immature statement right? well I'm chasing dopamine production which comes from things that are interesting and stimulating to me - A great way to help is, if possible, let me work on work that interests me - if not possible then perhaps allow protected time to work other new/novel/stimulating things - With tasks management sometimes the hardest part is just starting - So helping could simple by starting with tiny tasks and get momentum going and tackle progressively larger tasks - *Emotional Regulation* - **What It Looks Like:** - I often become a people pleaser and bend over backwards to accommodate others to avoid their ire - I avoid negativity, anger, hostility and are overly sensitive to rejection or even perceived negativity/rejection - I can get irrationally angry about inconsequential things - I can become very anxious about perceived outcomes/reactions and even if they do not come true I may fall into depression from processing these intense spikes of emotional pain - Feeling the effects of these emotional spikes are incredibly exhausting and often my ability to function even at a basic level tanks when I have a severe enough episode - Feeling hurt or angry when interrupted - **How To Help/Handle:** - Praise in public chastise in private **PLEASE** - A calm and level voice expressing displeasure is already emotionally deafening - I often can't read you and speaking plainly about your feelings and what you mean goes a long way to reduce miscommunication - Terse and curt emails and messages are very triggering for [[Rejection Sensitive Dysphoria causes people with ADHD to become people pleasers|RSD]] - I literally jump to conclusions impulsively and our emotional state spikes. - A great way of communicating easily while also assuaging my need for constant reinforcement that "YES IM OKAY, YOUR OKAY, EVERYTHING FINE" is emojis. - The simple usage of emoji's in text based communication makes it much easier to convey emotion than text. - Once I'm emotionally triggered with [[Rejection Sensitive Dysphoria causes people with ADHD to become people pleasers|RSD]] - The effects are strong, sharp, and quick - likely the episode will be acute and be over quickly. it's sharp and intense but short lived - but the emotional exhaustion that stems from processing these episodes is difficult to move past and continue on as normal. - Sometimes I can process and move onward if given some positive feedback. Other times it may be a write off - Often I like to gush and talk about something that has my interest and I may talk more than I need to/should about it - The best way to curb the conversation or pivot is not necessarily to interrupt as that appears like a sharp reprimand or a "YOU DID A BAD THING I DIDNT LIKE" - Rather a good way might be to visually capture my attention such as raising a hand and pulling my attention so the focus is on you and then gently pivoting the conversation away - but not reprimanding. Often when this happens personally I realize what I did and then i'm already feeling self conscious about it so like stated earlier a soft voice can be deafening - *Poor Working Memory* - **What It Looks Like:** - I often forget things in my short term memory, names, phone numbers, things said in passing, etc. - Often I need to write things down, post-its everywhere - **How To Help/Handle:** - The best way to give me direction is something I can refer back to later. (Referential Material). - Clear and concise notes, written instructions, or recorded video/audio - *Inattention* - **What It Looks Like:** - Often below the surface my attention is being pulled by a variety of stimuli - A car horn outside, the sound of the ice-maker in the fridge, the tapping your pen on the table, and my other thought processes. Because [[ADHD Brains are able to observe and interact with several subconsciouss processes simultaniously]] it means we also are subject to move "noise" - I Fidget (cracking knuckles, biting nail, tapping, bouncing, etc.) often as a way to focus on other stimuli - **How To Help/Handle:** - When there is too much stimulation going on and I'm getting overloaded - sometimes just pausing for me to collect myself may help - Do what you can to reduce the amount of stimulation occurring - visual/audio distractions (people walking outside the window, tapping, typing overly loudly) - Fidgeting and - *Perseveration* - **What It Looks Like:** - Being unable to move and let go of a task when the one I'm working on has been roadblocked and there's nothing more I can possible do to unblock it - Unable to leave someone alone if I hurt them and continually making it worse and badgering them further exacerbating [[Rejection Sensitive Dysphoria causes people with ADHD to become people pleasers|RSD]] - **How To Help/Handle:** - Being unable to let go of something and hyperfixating on it is a detriment to the working environment - There are several ways to help with this in the workplace: [[Perseveration similarly to executive dysfunction context switching causes abnormal and intense fixations to the detriment of the individual#Can Be Helped By|Perseveration]] - With hyperfixation on emotional conflict with others I'm usually desperate to try and make amends to fix the issue and hyperfixate on it until I do - often this also leads to apologizing just to make the issue go away - if the issue cannot be resolved immediately then something helpful to do if possible would be to speak plainly and clearly - "I love/like/respect you" `(depending on the relationship, partner, coworker, friend, etc)` "But I feel hurt and I need some space right now. We can return to this but for now I need to be left alone." - Maybe this is too much to do in the moment and in the heat of conflict but assuaging the [[Rejection Sensitive Dysphoria causes people with ADHD to become people pleasers|RSD]] will go a long way towards setting the precedent that arguments/conflicts are normal, not everything is CODE **RED** NUCLEAR, and that you are still loved/liked/respected but they just need a moment to breathe alone. - *Sensory Processing Issues* - **What It Looks Like:** - Sometimes visual input is too distracting when people are talking to me - So I may look away completely and look like i'm rudely ignoring you when in fact i'm 100% focused on the audio input - likely I can repeat back to you what you said verbatim if i'm actively listening in this manner - Too much auditory stimulation can sometimes inspire irrational anger - people talking over each other in a meeting room - **How To Help/Handle:** - Be understanding of my communication style when I may not be looking at you yet i'm still actively listening - I may also not be [[Neurodivergent brains like those with ADHD mask to fit in better amongst neurotypicals but this is exhausting|masking]] and not doing those little social queues other are used to receiving such as: - nodding constantly during conversation, "mmhmm", eye contact, etc. - Often these little social cues do not come naturally to me and therefore require active energy and attention to put forth in the [[Neurodivergent brains like those with ADHD mask to fit in better amongst neurotypicals but this is exhausting|mask]] - because masking takes attention it detracts from my ability to focus on what you're saying and it is also exhausting to maintain --- References: - Related: - [[Neurodivergent]]