ADHD Answers

How can I feel present in the world again?

I am so sorry to hear that you are struggling with being present and sometimes that can become a way of coping.  It will be important to recognize when your feelings have a purpose versus when they do not.  We of course want positive feelings in our lives, but sometimes negative feelings are there for a reason and we need to live out that purpose in order for it to get better.  If we do not live out the purpose of our feelings, it likely leads us to feel worse.  For example, something as simple as having anxiety about needing to get the chores done has the purpose of getting us motivated to get the chores done.  Therefore, if we do not live out that purpose and the chores remain undone, that can lead to more bad feelings, such as, “I am lazy” or “I am worthless.”  This is a simple example of how if we do not pay attention to our feelings and live out the purpose, they can become much, much worse.  So, I would encourage you to try and separate out the thoughts that have a purpose from the thoughts that do not have a purpose and are more intrusive.    For the ones that do have a purpose, it can be helpful to allow yourself to think through the anxious thoughts because anxiety has a nasty way of going to the worst possible scenario.  If you can wrap your head around that scenario, it can make it less scary.  For example, I had a client that was very anxious daily about being single for the rest of his life.  Thinking to that extreme is clearly anxiety and it just lingers there.  So, then he was able to think through that scenario and come up with a plan to make it less scary.  He then came up with that if he really is going to be single the rest of his life, which is highly unlikely, he is going to work towards being able to live close to the ocean since that is a dream of his.  Thinking about it now does not make him as scared because he recognizes he could be happy with that. So, try to think through specific things you are anxious about that have a purpose and make sure you have a specific plan on how to improve those things. For example, having a specific plan for how to address specific parts of your life that you want to be more present in.     Intrusive thoughts tend to not have a purpose and it can be really helpful to try and overpower those before they are accepted as truths.   We can have power over our thoughts and I want to help you not engage in these thoughts that make you so upset.  The easiest example of this that I can think of is if I went skydiving.  If I went skydiving I would have some obvious, rational, anxious thoughts.  If I really have a desire to skydive though I will need to not engage in those thoughts.  I might have thoughts such as, "My parachute could fail, I will hit the ground, I am going to pass out, etc."  However, since I really want to follow through with skydiving, I would want to stop those thoughts in their tracks with, "I know this is going to be really fun, they inspect the parachutes ahead of time, people hardly ever get hurt doing this, etc."  By focusing on those thoughts and not engaging in the others, I would be able to follow through with skydiving. Try to sort through any thoughts that get you down about yourself and that you can’t handle all of this and try to overpower those.  These types of thoughts are very common when dealing with this kind of lack of being present.                       As you do those processes it can be helpful to validate yourself as someone whose life has worth and that has been able to get through challenges in your past.  Something that could be helpful for you is what I like to call centering thoughts.  These are thoughts that are predetermined and unique to you for you to turn to in low moments.  They need to be powerful enough to bring you back to your center.  It is important that these thoughts are accessible for you to look at when you need to.  Some clients prefer to read and re-read them and some prefer to write and re-write them until they feel better.  I have clients that write these somewhere they will see daily such as their bathroom mirror or phone background, while others simply have them in their phone to pull out when they need to.  An example of a centering thought would be from a client I had that related to nautical-themed things and her thought was, "I will not let this sink me."  Another example is from an Olympic skier that actually had difficulties with negative thinking getting in the way of her performance so she went to therapy.  She mentioned that she learned about centering thoughts to battle all of the people telling her she “should be” or “should do.”  To battle those thoughts, she uses the simple centering thought of, “I am.”  She can then remind herself that she is good enough, that she is confident, and that she does want to still compete, which really affirms her own feelings and not others.  Hopefully, you can come up with something that helps validate your worth and abilities to move forward.       I hope that some of this is helpful and that you can apply it to your circumstances.  I hope that you can lean on some family and/or friends through this.  Doing so can help take the weight off of your shoulders as well as hopefully get some valuable advice from them. Try to take the healing one day at a time and adding one positive thing back into your life each day. I wish you all the best and I hope that you are staying safe.
(MA, LPC, NCC)
Answered on 10/21/2021

Why do I struggle with memory and focus so bad?

Hi CG,  I can imagine that it can be very frustrating when you feel like you are unable to complete any tasks that you have planned for the day or feel overwhelmed with everything that you may have to complete. You mentioned that you feel that you have ADHD, have you struggled with focusing and paying attention in the past or is this a relatively new thing? If you consistantly feel like you are not able to focus and due to this you are not able to complete tasks then the next step I would encourage you to look into is speaking with your primary care doctor about this. Your doctor can sit down and really talk to you about what ADHD is and how symptoms can manifest differently for each individual.  Going to the doctor can really help you understand what the core sumptoms of ADHD are and sometimes the doctor can assess you using assessments or learning scales that can also help to determine if ADHD is what you are struggling with. Getting a proper diagnosis can alleviate a lot of anxiety but also help to develop a treatment plan. You mentioned that you also have trouble with planning and that if you have something planned out for the day it can be difficult for you to focus on other things due to the fear of missing your plans. I would like to once again ask, is this something that you have started to notice recently or is this something that you have struggled with for quite some time? I think a solution to this can be creating a daily schedule or getting a planner to write down the things that you hope to do and dedicate specific times and timeframes you would like to complete these tasks in. Writing down the tasks that you have to complete can give you a visual representation of your day and it will also help you to prioritize tasks and allocate appropriate timeframes for each task. Doing this I also feel may help you with your fear of missing things and it can also help you to stay organized and remember all the tasks that you have to complete.  I hope this has been helpful, all the best! Shafia Rahman LCSW, RN
(LCSW, RN)
Answered on 10/21/2021

How do I handle adhd symptoms unmedicated

Hello!   When you have ADHD, it can become difficult to decide which task is most important. It is also difficult to stick with the task until it is completed.  This exercise will teach you a concrete strategy to help you decide which tasks are most important.    Master List versus Daily List It is important to have both a “master list” that holds all of the tasks that need to be completed and a “daily list” of tasks that you are actually hoping to complete on a particular day. You can decide the list up into different sections, such as home projects and work projects if desired.  All tasks should remain in the master list until completed. If you do not complete a task on the daily list that day, move it to the next day’s list.   Prioritizing   When you are faced with a number of tasks that you must do, it is important to have a clear strategy for prioritizing which tasks are most important, so that the most important tasks are sure to get completed. A good way to do this is to rate each task.    Skill: The A, B, C’s   List all of your tasks. Then assign an A, B, or C rating to each task:    “A” Tasks: These tasks are the tasks of the highest importance. They must be completed in the short term (like today or tomorrow).   “B” tasks: These are lower-importance, longer-term tasks. Some portions should be completed in the short term, but other portions may take longer.    “C” Tasks: These are the tasks of lower importance. They may be more attractive and easier to do, but they are not as important.   Please generate a task list and rate them. Be very careful not to rate too many items as “A”.  This rating strategy can be applied to both the master list and the daily list. In the case of the master list, you can use it to decide which items are most important and need to go on the day’s list. In the case of the daily list, you will use it to decide which items to do first, which to do second, and so on.  You can see that the priority ratings are not static. For example, a task that needs to be completed in the distant future may be placed on your master list, and you might rate it as a “C”. However, as the deadline approaches, you may change the rating to a “B” and then finally to an “A” if you haven’t yet completed it. Sometimes, events will occur that may cause you to modify your ratings (e.g., an email from your boss asking about a task you were supposed to complete).    You can now add this technique to the toolbox of skills you are developing to combat your ADHD symptoms. In addition to making a to-do list for each day, you should now assign a rating of A, B, or C to each task. You should do all of the A tasks before doing any of the B tasks. This may be hard for you, but it is very important. It will help you to make sure that you complete the tasks that are important to you.  Use this technique every day. Get in the habit of pausing to assess what you need to do and to carefully decide what you should start with, what you should do second, and so on. By practicing this technique regularly, you will ensure that the most important tasks get completed.    You may get discouraged as you are trying to learn a new skill, and it will take some time before the skill becomes a habit. As you become more accustomed to using your tasks list, you will learn more about how much is realistic for you to expect to do in one day.      I hope this will help you with managing some of the ADHD symptoms!    Jinan 
Answered on 10/21/2021

Would I be able to get diagnosed with ADHD and referred to a psychiatrist?

We tend to not refer people to another professional, due to this being an online forum and forum. However, your primary care physician at home can write you a script for Adderall or State if he feels you meet the criteria.    In the meantime, you would probably do much better with a structured schedule each day, even breaking things down by the hour. Then you just look at your schedule and know what to do next. If you get distracted you will probably forget what you were doing in the 1st place, so it's best for you to just do one thing at a time until that becomes routine.    ADHD and autistic high-level functioning individuals tend to excel when they are able to have the freedom to create their own schedules. If you have that option at all at work or school, I would suggest you do what works for you, and not just listen to people who tell you what you need to do.    It doesn't matter what other people think as long as you are able to carry your workload or without having any anxiety. The most important thing to remember is that what other people think shouldn't matter as much as what you think.  If you find that what other people think is keeping you back from doing what you need to do, then you need to reschedule those things so that you are more comfortable with what is going on at work and school.    The ADHD medication does help with focus, but there is a tendency towards addiction, so if you have any addictive tendencies or have any addiction in your background. I would be starting off with very small doses just so that you can tell what is working for you.  You are allowed to tell your primary care physician what you are going through and he is allowed to prescribe those types of meds, without you having to see a psychiatrist - which will probably cost you a lot of money.  ADHD is not the end of the world and can be overcome by structure and by you having autonomy over your own schedule.
(LMHC, LPC, MCAP)
Answered on 10/21/2021

How do I keep my thoughts focused, centered around a subject, especially in working with school proj

Hello there, Feeling like you have 20 tabs open in your head constantly throughout the day sounds tiring and overwhelming. It makes me wonder if you have ever spoken to someone about whether or not you have anxiety or attention deficit disorder. I am not diagnosing you with either, I would need a lot of additional information before being able to do that, but from what little you shared with me those are the two things that crossed my mind. For anxiety, trying to focus on deep breathing and relaxing can be very beneficial. Taking in a deep breath for 3 seconds, holding for 3 seconds, breathing out for 3 seconds, and leaving your lungs empty for 3 seconds can be useful. Identifying scents that you find relaxing and/or soothing can be useful. Creating a relaxing, calm environment can be useful. Things that can help influence an environment are things like lighting, scent, temperature, the items in the room with you, etc.  Doing things like what I just mentioned can prove to be quite difficult if you are struggling with attention deficit disorder/attention deficit hyperactivity disorder. Slowing down, focusing, being in the present moment... those are all things that are extremely difficult when struggling with attention deficit disorder/attention deficit hyperactivity disorder. While some people with these diagnoses are able to manage them without medication, many people do find benefit from working with their primary care physician, or psychiatrist, and selecting a medication that allows them to manage the symptoms of ADD/ADHD. In some cases, an individual is not able to manage the symptoms on their own without the support of medication. This is not a character flaw or a reflection of the person, sometimes certain diagnoses just require some medicinal intervention. With all of that being said, a therapist or psychiatrist can help you in figuring out whether or not these diagnoses, or something else, are present. A primary care physician may also be able to help, but that will probably vary from doctor to doctor. I highly encourage you to get connected with one of these providers if you are in need of additional support.    
(LPC, NCC, CEDS-S)
Answered on 10/21/2021

Can i have an adhd diagnosis

Dear Adhd,   Thank you for your message and for sharing with me your thoughts.   Perhaps we can go into details a bit on what ADHD is and understand how it might be affecting our lives? Please note that if you would like to have an official diagnosis for ADHD, please talk to a local physician and seek referrals. I am not able to provide tests here for you.   According to the Mayo Clinic, adult attention-deficit/hyperactivity disorder (ADHD) is a mental health disorder that includes a combination of persistent problems, such as difficulty paying attention, hyperactivity and impulsive behavior. Adult ADHD can lead to unstable relationships, poor work or school performance, low self-esteem, and other problems.   Though it's called adult ADHD, symptoms start in early childhood and continue into adulthood. In some cases, ADHD is not recognized or diagnosed until the person is an adult. Adult ADHD symptoms may not be as clear as ADHD symptoms in children. In adults, hyperactivity may decrease, but struggles with impulsiveness, restlessness and difficulty paying attention may continue.   Treatment for adult ADHD is similar to treatment for childhood ADHD. Adult ADHD treatment includes medications, psychological counseling (psychotherapy) and treatment for any mental health conditions that occur along with ADHD.   Symptoms   Some people with ADHD have fewer symptoms as they age, but some adults continue to have major symptoms that interfere with daily functioning. In adults, the main features of ADHD may include difficulty paying attention, impulsiveness and restlessness. Symptoms can range from mild to severe.   Many adults with ADHD aren't aware they have it — they just know that everyday tasks can be a challenge. Adults with ADHD may find it difficult to focus and prioritize, leading to missed deadlines and forgotten meetings or social plans. The inability to control impulses can range from impatience waiting in line or driving in traffic to mood swings and outbursts of anger.   Adult ADHD symptoms may include:   Impulsiveness Disorganization and problems prioritizing Poor time management skills Problems focusing on a task Trouble multitasking Excessive activity or restlessness Poor planning Low frustration tolerance Frequent mood swings Problems following through and completing tasks Hot temper Trouble coping with stress   What's typical behavior and what's ADHD?   Almost everyone has some symptoms similar to ADHD at some point in their lives. If your difficulties are recent or occurred only occasionally in the past, you probably don't have ADHD. ADHD is diagnosed only when symptoms are severe enough to cause ongoing problems in more than one area of your life. These persistent and disruptive symptoms can be traced back to early childhood.   Diagnosis of ADHD in adults can be difficult because certain ADHD symptoms are similar to those caused by other conditions, such as anxiety or mood disorders. And many adults with ADHD also have at least one other mental health condition, such as depression or anxiety.   While the exact cause of ADHD is not clear, research efforts continue. Factors that may be involved in the development of ADHD include:   Genetics. ADHD can run in families, and studies indicate that genes may play a role. Environment. Certain environmental factors also may increase risk, such as lead exposure as a child. Problems during development. Problems with the central nervous system at key moments in development may play a role.   Risk factors   The risk of ADHD may increase if:   You have blood relatives, such as a parent or sibling, with ADHD or another mental health disorder   Your mother smoked, drank alcohol, or used drugs during pregnancy   As a child, you were exposed to environmental toxins — such as lead, found mainly in paint and pipes in older buildings   You were born prematurely   Complications   ADHD can make life difficult for you. ADHD has been linked to:   Poor school or work performance Unemployment Financial problems The trouble with the law Alcohol or other substance misuses Frequent car accidents or other accidents Unstable relationships Poor physical and mental health Poor self-image Suicide attempts Coexisting conditions   Although ADHD doesn't cause other psychological or developmental problems, other disorders often occur along with ADHD and make treatment more challenging. These include:   Mood disorders. Many adults with ADHD also have depression, bipolar disorder or another mood disorder. While mood problems aren't necessarily due directly to ADHD, a repeated pattern of failures and frustrations due to ADHD can worsen depression.   Anxiety disorders. Anxiety disorders occur fairly often in adults with ADHD. Anxiety disorders may cause overwhelming worry, nervousness and other symptoms. Anxiety can be made worse by the challenges and setbacks caused by ADHD.   Other psychiatric disorders. Adults with ADHD are at increased risk of other psychiatric disorders, such as personality disorders, intermittent explosive disorder and substance use disorders.   Learning disabilities. Adults with ADHD may score lower on academic testing than would be expected for their age, intelligence and education. Learning disabilities can include problems with understanding and communicating.   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   • When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   • You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   • Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   • Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   • Take a few more deep breaths and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   • Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   • The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   • You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   • Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   • You may need to focus on this sensation for anything from a few seconds to a few minutes until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   • Once you've done this, scan your body again and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   • You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   • As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 10/21/2021

Can therapy be useful for managing and coping with ADHD?

I am so sorry to hear that you are struggling with reckless behaviors as a result of ADHD.  It will be important to recognize when your feelings have a purpose versus when they do not.  We of course want positive feelings in our lives, but sometimes negative feelings are there for a reason and we need to live out that purpose in order for it to get better.  If we do not live out the purpose of our feelings, it likely leads us to feel worse.  For example, something as simple as having anxiety about needing to get the chores done has the purpose of getting us motivated to get the chores done.  Therefore, if we do not live out that purpose and the chores remain undone, that can lead to more bad feelings, such as, “I am lazy” or “I am worthless.”  This is a simple example of how if we do not pay attention to our feelings and live out the purpose, they can become much, much worse.  So, I would encourage you to try and separate out the thoughts that have a purpose from the thoughts that do not have a purpose and are more intrusive.    For the ones that do have a purpose, it can be helpful to allow yourself to think through the anxious thoughts because anxiety has a nasty way of going to the worst possible scenario.  If you can wrap your head around that scenario, it can make it less scary.  For example, I had a client that was very anxious daily about being single for the rest of his life.  Thinking to that extreme is clearly anxiety and it just lingers there.  So, then he was able to think through that scenario and come up with a plan to make it less scary.  He then came up with that if he really is going to be single the rest of his life, which is highly unlikely, he is going to work towards being able to live close to the ocean since that is a dream of his.  Thinking about it now does not make him as scared because he recognizes he could be happy with that. So, try to think through specific things you are anxious about that have a purpose and make sure you have a specific plan on how to improve those things. For example, having a specific plan for how to address specific reckless behaviors you are noticing are a pattern in your life.      Intrusive thoughts tend to not have a purpose and it can be really helpful to try and overpower those before they are accepted as truths.   We can have power over our thoughts and I want to help you not engage in these thoughts that make you so upset.  The easiest example of this that I can think of is if I went skydiving.  If I went skydiving I would have some obvious, rational, anxious thoughts.  If I really have a desire to skydive though I will need to not engage in those thoughts.  I might have thoughts such as, "My parachute could fail, I will hit the ground, I am going to pass out, etc."  However, since I really want to follow through with skydiving, I would want to stop those thoughts in their tracks with, "I know this is going to be really fun, they inspect the parachutes ahead of time, people hardly ever get hurt doing this, etc."  By focusing on those thoughts and not engaging in the others, I would be able to follow through with skydiving. Try to sort through any thoughts that get you down about yourself and that you can’t handle all of this and try to overpower those.  These types of thoughts are very common when dealing with ADHD-like symptoms.        As you do those processes it can be helpful to validate yourself as someone of worth and that has been able to get through challenges in your past.  Something that could be helpful for you is what I like to call centering thoughts.  These are thoughts that are predetermined and unique to you for you to turn to in low moments.  They need to be powerful enough to bring you back to your center.  It is important that these thoughts are accessible for you to look at when you need to.  Some clients prefer to read and re-read them and some prefer to write and re-write them until they feel better.  I have clients that write these somewhere they will see daily such as their bathroom mirror or phone background, while others simply have them in their phone to pull out when they need to.  An example of a centering thought would be from a client I had that related to nautical-themed things and her thought was, "I will not let this sink me."  Another example is from an Olympic skier that actually had difficulties with negative thinking getting in the way of her performance so she went to therapy.  She mentioned that she learned about centering thoughts to battle all of the people telling her she “should be” or “should do.”  To battle those thoughts, she uses the simple centering thought of, “I am.”  She can then remind herself that she is good enough, that she is confident, and that she does want to still compete, which really affirms her own feelings and not others.  Hopefully, you can come up with something that helps validate your worth and abilities to move forward.       I hope that some of this is helpful and that you can apply it to your circumstances.  I hope that you can lean on some family and/or friends through this.  Doing so can help take the weight off of your shoulders as well as hopefully get some valuable advice from them. Try to take the healing one day at a time and adding one positive thing back into your life each day. I wish you all the best and I hope that you are staying safe.
(MA, LPC, NCC)
Answered on 10/21/2021

1. How to treat ADHD? Or attempt to treat it, to get better?

Dear Gift,   Thank you for your message and for sharing with me your thoughts.   Perhaps we can go into details a bit on what ADHD is and understand how it might be affecting our lives? Please note that if you would like to have an official diagnosis for ADHD, please talk to a local physician and seek referrals. I am not able to provide tests here for you.   According to the Mayo Clinic, adult attention-deficit/hyperactivity disorder (ADHD) is a mental health disorder that includes a combination of persistent problems, such as difficulty paying attention, hyperactivity and impulsive behavior. Adult ADHD can lead to unstable relationships, poor work or school performance, low self-esteem, and other problems.   Though it's called adult ADHD, symptoms start in early childhood and continue into adulthood. In some cases, ADHD is not recognized or diagnosed until the person is an adult. Adult ADHD symptoms may not be as clear as ADHD symptoms in children. In adults, hyperactivity may decrease, but struggles with impulsiveness, restlessness and difficulty paying attention may continue.   Treatment for adult ADHD is similar to treatment for childhood ADHD. Adult ADHD treatment includes medications, psychological counseling (psychotherapy) and treatment for any mental health conditions that occur along with ADHD.   Symptoms   Some people with ADHD have fewer symptoms as they age, but some adults continue to have major symptoms that interfere with daily functioning. In adults, the main features of ADHD may include difficulty paying attention, impulsiveness and restlessness. Symptoms can range from mild to severe.   Many adults with ADHD aren't aware they have it — they just know that everyday tasks can be a challenge. Adults with ADHD may find it difficult to focus and prioritize, leading to missed deadlines and forgotten meetings or social plans. The inability to control impulses can range from impatience waiting in line or driving in traffic to mood swings and outbursts of anger.   Adult ADHD symptoms may include:   Impulsiveness Disorganization and problems prioritizing Poor time management skills Problems focusing on a task Trouble multitasking Excessive activity or restlessness Poor planning Low frustration tolerance Frequent mood swings Problems following through and completing tasks Hot temper Trouble coping with stress   What's typical behavior and what's ADHD?   Almost everyone has some symptoms similar to ADHD at some point in their lives. If your difficulties are recent or occurred only occasionally in the past, you probably don't have ADHD. ADHD is diagnosed only when symptoms are severe enough to cause ongoing problems in more than one area of your life. These persistent and disruptive symptoms can be traced back to early childhood.   Diagnosis of ADHD in adults can be difficult because certain ADHD symptoms are similar to those caused by other conditions, such as anxiety or mood disorders. And many adults with ADHD also have at least one other mental health condition, such as depression or anxiety.   While the exact cause of ADHD is not clear, research efforts continue. Factors that may be involved in the development of ADHD include:   Genetics. ADHD can run in families, and studies indicate that genes may play a role. Environment. Certain environmental factors also may increase risk, such as lead exposure as a child. Problems during development. Problems with the central nervous system at key moments in development may play a role.   Risk factors   The risk of ADHD may increase if:   You have blood relatives, such as a parent or sibling, with ADHD or another mental health disorder   Your mother smoked, drank alcohol, or used drugs during pregnancy   As a child, you were exposed to environmental toxins — such as lead, found mainly in paint and pipes in older buildings   You were born prematurely   Complications   ADHD can make life difficult for you. ADHD has been linked to:   Poor school or work performance Unemployment Financial problems The trouble with the law Alcohol or another substance misuse Frequent car accidents or other accidents Unstable relationships Poor physical and mental health Poor self-image Suicide attempts Coexisting conditions   Although ADHD doesn't cause other psychological or developmental problems, other disorders often occur along with ADHD and make treatment more challenging. These include:   Mood disorders. Many adults with ADHD also have depression, bipolar disorder or another mood disorder. While mood problems aren't necessarily due directly to ADHD, a repeated pattern of failures and frustrations due to ADHD can worsen depression.   Anxiety disorders. Anxiety disorders occur fairly often in adults with ADHD. Anxiety disorders may cause overwhelming worry, nervousness and other symptoms. Anxiety can be made worse by the challenges and setbacks caused by ADHD.   Other psychiatric disorders. Adults with ADHD are at increased risk of other psychiatric disorders, such as personality disorders, intermittent explosive disorder and substance use disorders.   Learning disabilities. Adults with ADHD may score lower on academic testing than would be expected for their age, intelligence and education. Learning disabilities can include problems with understanding and communicating.   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   • When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   • You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   • Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   • Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   • Take a few more deep breaths and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   • Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   • The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   • You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   • Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   • You may need to focus on this sensation for anything from a few seconds to a few minutes until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   • Once you've done this, scan your body again and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   • You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   • As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 10/21/2021

How can I manage ADHD with a very busy schedule? How am I sure it is actually ADHD?

Thanks for submitting your question to this platform.  It sounds like you have a lot going on!  You mentioned that you must suppress your hyperactivity during the day and overdo it at home.  My first question is “Do you have any daytime coping techniques during work that allows you to release some of your energy?”.  For instance, do you have a stress relief ball you can squeeze during the day, can you go to a private place during the day and do a few squats, shadow boxing, or perhaps pushups?  You need some type of release during the day.  A brief physical activity throughout the day would allow this.  If this happens, you could release some of that pent-up energy.  If you could resume the boxing classes that will help you as you stated it was very beneficial.   The second question I have is “What is your morning routine before you go to work?”.  If you are jumping out the bed and rushing to get to work, you have set a rushed pattern for your day.  I recommend a few minutes (3-5) of deep breathing (breath slowly in through your nose and slowly release it through your mouth) and meditation as soon as you awake daily.  This routine will help you to center your energy and focus your day.  Instead of your day beginning in a rushed fashion, it will begin on a more thoughtful practice.  The third and final question is “What does your diet consist of?”.  What you consume has a major impact on your mental state.  I like to say, “Junk in, Junk out”, “Good in, Good Out”.  Look at your diet and see what you are consuming.  Are the foods mostly processed, or whole food?  Do you consume a large amount of sugar or caffeine?  If so, this could be contributed to your hyperactivity. I cannot render a diagnosis to you based upon a message, but from what you mentioned you have some of the characteristics of ADHD.  Until you can be properly diagnosed, try to suggestions I have given you.  I hope this helps.  My Best!
Answered on 10/21/2021

What would indicate the need for an ADHD meds?

Hi there, thank you for your question. I can see that you were frustrated, and I totally understand that as a person with ADHD myself. I have worked with hundreds of people with this condition, and I can tell you that the process of testing can be quite cumbersome and expensive. There are people out there that will rally around the idea of self-diagnosis, so unless you want to look into stimulant medication or just want to have actual documentation, neuro psych testing is not absolutely necessary. If you already know or have a strong sense that you have this condition, then you could avoid the expensive and time-consuming testing. One of the things that you mentioned was his idea of being frustrated with high distractibility. There are things you can do to limit distractions, such as managing your environment. Also, you may wanna look into sensory stimulation tools, we sometimes call these fidgets. It can be music, movement, smells, give it a Google. Sensory stimulation is the way that folks with this condition are able to tune into things a little bit more. It also helps with absorbing information. One of my favorite ways to do this is to play music in the background while I'm listening to a lecture or something. Also while I'm talking on the phone I might pace back-and-forth. One of my clients loves chewing on ice while he is in class or listening to something that may not be as interesting. You may also find that you rock back and forth in a chair when you are trying to pay attention. These are all examples of sensory stimulation. You can use them to your advantage. you also mentioned wanting to have a clear mind. Try using physical activity when you first get up in the morning, as it releases built-up cortisol that often impacts our ability to focus. there are tons of resources online for this condition, one of my favorites is a person on Tik Tok called journey2adhd. He gives practical information about the condition and ways to overcome some of the limitations. For instance, he speaks a lot about dopamine deficiencies and how folks with this condition wake up with less than a full tank of motivation. What this translates to is having to do things throughout our day to build our motivation, to increase and release our dopamine. Check him out, I hope this is helpful. There are also some supplements that you may want to look into. L tyrosine, magnesium is just a couple of them.     
(LPC, LPC/S, MAC)
Answered on 10/21/2021

Can I get help confirming a diagnosis given to me years ago?

Hi. Thank you for reaching out to me to ask this question. Very important to determine what are the typical practices on BetterHelp and the limitations of the Online counseling telehealth platform. Based on the information you have provided me on your history of psychiatric hospitalization and use of antidepressants, as well as diagnoses of ADHD and Borderline Personality Disorder, I will emphasize the major components of a Comprehensive Clinical Assessment to evaluate you most appropriately to be able to identify the BEST treatment option to your disorders and needs. During a Clinical Assessment, most ideally in an office, in-person setting, a lot of information is going to be asked, documented, and taken into account based on History, Present, and Goals you want to achieve. The clinical recommendations of these assessments will include the treatment options; however, the important aspect of a Clinical Assessment is to document the past and current symptoms you are experiencing-the frequency and the severity, to properly identify the most accurate diagnoses. You stated you were diagnosed with BPD and ADHD at the age of 15. A very difficult time in development to be 100% accurate with diagnosing due to the many brain chemistry changes/development occurring in the time and the great influence of family, society, and supports/friends. At your age of 20, there is still a lot of similar aspects that can affect diagnosing in your life-BUT you are now over the age of 18, the assessment can be more accurate in the sense of considering your current life aspects that are in your life. All diagnoses of the DSM5 (diagnostic book) are now applicable to you because you are past age 18 and the reason for this is because a child is going through so much that their symptoms could be behavioral responses to other stimuli rather than their own chemistry portraying those symptoms.   I highly recommend you receive a more in-depth Clinical Assessment to determine your CURRENT symptom frequency and severity-and ask questions to all providers that make recommendations of your care. Always advocate for yourself and ask why they believe those are the best treatment options for you and if they outweigh the risks they have.
(MSW, LCSW)
Answered on 10/21/2021

I was wondering how easy it would be diagnosed for ADHD online?

Dear Nynx,   Thank you for your message and for sharing with me your thoughts.   It's usually recommended to seek evaluation/testing for ADHD in person rather than online. However, perhaps we can go into detail a bit on what ADHD is and understand how it might be affecting our lives? Please note that if you would like to have an official diagnosis for ADHD, please talk to a local physician and seek referrals. I am not able to provide tests here for you.   According to the Mayo Clinic, adult attention-deficit/hyperactivity disorder (ADHD) is a mental health disorder that includes a combination of persistent problems, such as difficulty paying attention, hyperactivity, and impulsive behavior. Adult ADHD can lead to unstable relationships, poor work or school performance, low self-esteem, and other problems.   Though it's called adult ADHD, symptoms start in early childhood and continue into adulthood. In some cases, ADHD is not recognized or diagnosed until the person is an adult. Adult ADHD symptoms may not be as clear as ADHD symptoms in children. In adults, hyperactivity may decrease, but struggles with impulsiveness, restlessness, and difficulty paying attention may continue.   Treatment for adult ADHD is similar to treatment for childhood ADHD. Adult ADHD treatment includes medications, psychological counseling (psychotherapy), and treatment for any mental health conditions that occur along with ADHD.   Symptoms   Some people with ADHD have fewer symptoms as they age, but some adults continue to have major symptoms that interfere with daily functioning. In adults, the main features of ADHD may include difficulty paying attention, impulsiveness, and restlessness. Symptoms can range from mild to severe.   Many adults with ADHD aren't aware they have it — they just know that everyday tasks can be a challenge. Adults with ADHD may find it difficult to focus and prioritize, leading to missed deadlines and forgotten meetings or social plans. The inability to control impulses can range from impatience waiting in line or driving in traffic to mood swings and outbursts of anger.   Adult ADHD symptoms may include:   Impulsiveness Disorganization and problems prioritizing Poor time management skills Problems focusing on a task Trouble multitasking Excessive activity or restlessness Poor planning Low frustration tolerance Frequent mood swings Problems following through and completing tasks Hot temper Trouble coping with stress   What's typical behavior and what's ADHD?   Almost everyone has some symptoms similar to ADHD at some point in their lives. If your difficulties are recent or occurred only occasionally in the past, you probably don't have ADHD. ADHD is diagnosed only when symptoms are severe enough to cause ongoing problems in more than one area of your life. These persistent and disruptive symptoms can be traced back to early childhood.   Diagnosis of ADHD in adults can be difficult because certain ADHD symptoms are similar to those caused by other conditions, such as anxiety or mood disorders. And many adults with ADHD also have at least one other mental health condition, such as depression or anxiety.   While the exact cause of ADHD is not clear, research efforts continue. Factors that may be involved in the development of ADHD include:   Genetics. ADHD can run in families, and studies indicate that genes may play a role. Environment. Certain environmental factors also may increase risk, such as lead exposure as a child. Problems during development. Problems with the central nervous system at key moments in development may play a role.   Risk factors   The risk of ADHD may increase if:   You have blood relatives, such as a parent or sibling, with ADHD or another mental health disorder   Your mother smoked, drank alcohol, or used drugs during pregnancy   As a child, you were exposed to environmental toxins — such as lead, found mainly in paint and pipes in older buildings   You were born prematurely   Complications   ADHD can make life difficult for you. ADHD has been linked to:   Poor school or work performance Unemployment Financial problems The trouble with the law Alcohol or another substance misuse Frequent car accidents or other accidents Unstable relationships Poor physical and mental health Poor self-image Suicide attempts Coexisting conditions   Although ADHD doesn't cause other psychological or developmental problems, other disorders often occur along with ADHD and make treatment more challenging. These include:   Mood disorders. Many adults with ADHD also have depression, bipolar disorder, or another mood disorder. While mood problems aren't necessarily due directly to ADHD, a repeated pattern of failures and frustrations due to ADHD can worsen depression.   Anxiety disorders. Anxiety disorders occur fairly often in adults with ADHD. Anxiety disorders may cause overwhelming worry, nervousness, and other symptoms. Anxiety can be made worse by the challenges and setbacks caused by ADHD.   Other psychiatric disorders. Adults with ADHD are at increased risk of other psychiatric disorders, such as personality disorders, intermittent explosive disorder, and substance use disorders.   Learning disabilities. Adults with ADHD may score lower on academic testing than would be expected for their age, intelligence and education. Learning disabilities can include problems with understanding and communicating.   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   • When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   • You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   • Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   • Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   • Take a few more deep breaths and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   • Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   • The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   • You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   • Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   • You may need to focus on this sensation for anything from a few seconds to a few minutes until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   • Once you've done this, scan your body again and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   • You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   • As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 10/21/2021

How do i deal with undiagnosed ADHD? How to even make sure i have it?

Dear August,  Thanks for reaching out with this question! I first want to recognize the strength and courage that it takes to reach out for support. I understand that it is not always easy to name the challenges you are facing and at the same time, this is a necessary first step in the change process. It appears that you are experiencing any symptoms currently in your life that are causing you some distress and that you are seeking both a way to clarify diagnosis and improve functioning. First and foremost, I would recommend seeking out a diagnostic assessment to seek clarification on what is occurring with a clinical provider. The symptoms you described above (and even those of ADHD) can overlap with many other medical and mental health diagnoses. This step will not only rule out more organic reasons for these symptoms but will help with treatment recommendations. You could start by visiting your primary care provider and discussing your concerns to determine an appropriate referral to a mental health provider. A thorough diagnostic assessment will look at your history, current presentation through a clinical interview and likely will include a formal measurement to better determine the cause of your symptoms.  I know you mention concern for attention-deficit/hyperactivity disorder (ADHD) specifically, so I will provide a little information about this mental health disorder. It typically includes a combination of persistent problems, such as difficulty paying attention, hyperactivity, and impulse behavior. As a result of these symptoms, adults with ADHD can have unstable relationships, poor work or school performance, low self-esteem, and other problems.  Symptoms of ADHD start in childhood and persist into adulthood. Sometimes, ADHD is not recognized or diagnosed in people until adulthood, which can make diagnosis a little more complicated. Adults typically present with less hyperactivity, while struggles with impulsiveness, restlessness, and difficulty paying attention may continue. Other symptoms may include disorganization, poor time management skills, trouble multi-tasking, poor planning, low frustration tolerance, frequent mood swings, or trouble coping with stress.  The exact cause of ADHD is not known, but genetics, certain environmental factors, and differences in the way our brains are wired are all factors that may be involved in the development of ADHD. Your risk of ADHD increases if you have a blood relative with ADHD or another mental health disorder, your mother smoked or used substances during pregnancy, you were exposed to environmental toxins, or born prematurely.  The good news is that many treatment options are available for ADHD. Often times we think about medication options for ADHD. These can be helpful for improving concentration and focus. Outside of medication, therapy can be helpful for both learning new skills to cope and changing unhelpful habits. Cognitive-Behavioral Therapy (CBT) is a common therapy used to treat ADHD. It encourages clients to identify and change the negative beliefs and behaviors that are causing problems in your life. It focuses on the practical issues that often come with ADHD, such as disorganization, work performance issues, and poor time management.  Lifestyle changes can also be effective to incorporate for better symptom management. These may be explored by your mental health professional or changes you adapt on your own. Things like ensuring you get regular exercise and sleep will be important. Managing your diet by avoiding junk food and reducing caffeine and sugar will be helpful. Utilizing relaxation techniques into your daily routine, like mindfulness meditation or yoga will be helpful for increasing attention and focus and decreasing impulsivity, anxiety, and depression.  Again, I would recommend starting with a formal assessment to figure out what is the cause of your symptoms. Whether the diagnosis is ADHD or something else, support and treatment options are available to help you work toward functioning better.  Best,  Kelsey Place, MSW, LICSW
(MSW, LICSW)
Answered on 10/21/2021

Can ADHD go under the radar in childhood and continue until adulthood?

Dear Eth,   Thank you for your message and for sharing with me your thoughts.   Perhaps we can go into details a bit on what ADHD is and understand how it might be affecting our lives? Please note that if you would like to have an official diagnosis for ADHD, please talk to a local physician and seek referrals. I am not able to provide tests here for you.   According to the Mayo Clinic, adult attention-deficit/hyperactivity disorder (ADHD) is a mental health disorder that includes a combination of persistent problems, such as difficulty paying attention, hyperactivity, and impulsive behavior. Adult ADHD can lead to unstable relationships, poor work or school performance, low self-esteem, and other problems.   Though it's called adult ADHD, symptoms start in early childhood and continue into adulthood. In some cases, ADHD is not recognized or diagnosed until the person is an adult. Adult ADHD symptoms may not be as clear as ADHD symptoms in children. In adults, hyperactivity may decrease, but struggles with impulsiveness, restlessness, and difficulty paying attention may continue.   Treatment for adult ADHD is similar to treatment for childhood ADHD. Adult ADHD treatment includes medications, psychological counseling (psychotherapy), and treatment for any mental health conditions that occur along with ADHD.   Symptoms   Some people with ADHD have fewer symptoms as they age, but some adults continue to have major symptoms that interfere with daily functioning. In adults, the main features of ADHD may include difficulty paying attention, impulsiveness, and restlessness. Symptoms can range from mild to severe.   Many adults with ADHD aren't aware they have it — they just know that everyday tasks can be a challenge. Adults with ADHD may find it difficult to focus and prioritize, leading to missed deadlines and forgotten meetings or social plans. The inability to control impulses can range from impatience waiting in line or driving in traffic to mood swings and outbursts of anger.   Adult ADHD symptoms may include:   Impulsiveness Disorganization and problems prioritizing Poor time management skills Problems focusing on a task Trouble multitasking Excessive activity or restlessness Poor planning Low frustration tolerance Frequent mood swings Problems following through and completing tasks Hot temper Trouble coping with stress   What's typical behavior and what's ADHD?   Almost everyone has some symptoms similar to ADHD at some point in their lives. If your difficulties are recent or occurred only occasionally in the past, you probably don't have ADHD. ADHD is diagnosed only when symptoms are severe enough to cause ongoing problems in more than one area of your life. These persistent and disruptive symptoms can be traced back to early childhood.   Diagnosis of ADHD in adults can be difficult because certain ADHD symptoms are similar to those caused by other conditions, such as anxiety or mood disorders. And many adults with ADHD also have at least one other mental health condition, such as depression or anxiety.   While the exact cause of ADHD is not clear, research efforts continue. Factors that may be involved in the development of ADHD include:   Genetics. ADHD can run in families, and studies indicate that genes may play a role. Environment. Certain environmental factors also may increase risk, such as lead exposure as a child. Problems during development. Problems with the central nervous system at key moments in development may play a role.   Risk factors   The risk of ADHD may increase if:   You have blood relatives, such as a parent or sibling, with ADHD or another mental health disorder   Your mother smoked, drank alcohol, or used drugs during pregnancy   As a child, you were exposed to environmental toxins — such as lead, found mainly in paint and pipes in older buildings   You were born prematurely   Complications   ADHD can make life difficult for you. ADHD has been linked to:   Poor school or work performance Unemployment Financial problems The trouble with the law Alcohol or other substance misuses Frequent car accidents or other accidents Unstable relationships Poor physical and mental health Poor self-image Suicide attempts Coexisting conditions   Although ADHD doesn't cause other psychological or developmental problems, other disorders often occur along with ADHD and make treatment more challenging. These include:   Mood disorders. Many adults with ADHD also have depression, bipolar disorder or another mood disorder. While mood problems aren't necessarily due directly to ADHD, a repeated pattern of failures and frustrations due to ADHD can worsen depression.   Anxiety disorders. Anxiety disorders occur fairly often in adults with ADHD. Anxiety disorders may cause overwhelming worry, nervousness, and other symptoms. Anxiety can be made worse by the challenges and setbacks caused by ADHD.   Other psychiatric disorders. Adults with ADHD are at increased risk of other psychiatric disorders, such as personality disorders, intermittent explosive disorder, and substance use disorders.   Learning disabilities. Adults with ADHD may score lower on academic testing than would be expected for their age, intelligence and education. Learning disabilities can include problems with understanding and communicating.   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   • When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   • You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   • Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   • Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   • Take a few more deep breaths and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   • Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   • The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   • You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   • Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   • You may need to focus on this sensation for anything from a few seconds to a few minutes until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   • Once you've done this, scan your body again and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   • You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   • As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 10/21/2021

can I be diagnosed with ADHD through better help?

I appreciate your thorough question and reasoning. You have provided helpful background information, allowing me space to hopefully provide you with a useful and informative response.  ADHD criteria, according to the DSM-5, provides a list of symptoms for one to be diagnosed with ADHD; it is an accumulation of symptoms. I'm not going to provide an exhaustive list, but include some things that might be helpful to understand the diagnosis more thoroughly. ADHD is marked by having difficulty with attention to detail, careless mistakes at schoolwork, work, and other activities, difficulties with attention span, difficulty following or following through with instructions, difficulty with organization, easily distracted, etc...To receive a proper diagnosis, I would make an appointment with a psychologist and request some psychological testing to determine if this is the proper diagnosis. From there, they can suggest medications that might be most appropriate for you.  As I read through your statement, I see that you have experienced some emotional, mental and physical trauma. Trauma can also affect one's concentration, ability to complete tasks, difficulty in school, affect self-esteem and self-confidence and even affect socialization with others. I do not want to discourage you from seeking a diagnosis if there is one, however, I would like you to also consider seeking therapy to address your family dynamics and how it has and is currently affecting your daily living. It appears moving out of the family home has lessened some of your emotional distress, but you continue to have some social concerns. Fortunately, you were able to move out on your own, unfortunately, your past always comes with you. Without addressing those memories, learned beliefs, and experiences, moving forward may have its difficulties. Attachment is an important part of a healthy child's emotional development. A child thrives with a healthy attachment to one or more caregivers. When that does not happen, children can have difficulty emotionally and socially even into adulthood. Adults that lack healthy attachment can experience a lack of trust in others, be more impulsive and struggle with intimacy. Those who experience trauma can also experience confusion, anxiety, impulsivity, and social alienation, and avoidance. My suggestion is to seek out a psychologist that can assess you and also seek out a therapist that can assist you in processing your trauma and provide you with healthy tools to successfully move forward.  I hope this answers your question and provides you with some direction in how to move forward. 
(MA, LPC)
Answered on 10/21/2021

Why do i forget things easily? Why do i cry easily? Why do i need assurance about everything?

Hello there, It sounds like you could be struggling with anxiety, depression, and/or ADD. I want to provide you with the deinitions of those three things so that you can assess for yourself what may be going on, and then decide from there if you want to make an appointment with your primary care physician. These responses were taken from other websites for the sake of specific explanation and accuracy. DSM-5 Criteria for ADHD People with ADHD show a persistent pattern of inattention and/or hyperactivity–impulsivity that interferes with functioning or development: Inattention: Six or more symptoms of inattention for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level: Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities. Often has trouble holding attention on tasks or play activities. Often does not seem to listen when spoken to directly. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked). Often has trouble organizing tasks and activities. Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework). Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones). Is often easily distracted Is often forgetful in daily activities. Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level: Often fidgets with or taps hands or feet, or squirms in seat. Often leaves seat in situations when remaining seated is expected. Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless). Often unable to play or take part in leisure activities quietly. Is often “on the go” acting as if “driven by a motor”. Often talks excessively. Often blurts out an answer before a question has been completed. Often has trouble waiting their turn. Often interrupts or intrudes on others (e.g., butts into conversations or games) In addition, the following conditions must be met: Several inattentive or hyperactive-impulsive symptoms were present before age 12 years. Several symptoms are present in two or more settings, (such as at home, school or work; with friends or relatives; in other activities). There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning. The symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder. Based on the types of symptoms, three kinds (presentations) of ADHD can occur: Combined Presentation: if enough symptoms of both criteria inattention and hyperactivity-impulsivity were present for the past 6 months Predominantly Inattentive Presentation: if enough symptoms of inattention, but not hyperactivity-impulsivity, were present for the past six months Predominantly Hyperactive-Impulsive Presentation: if enough symptoms of hyperactivity-impulsivity, but not inattention, were present for the past six months. Because symptoms can change over time, the presentation may change over time as well. Diagnosing  ADHD in Adults ADHD often lasts into adulthood. To diagnose ADHD in adults and adolescents age 17 years or older, only 5 symptoms are needed instead of the 6 needed for younger children. Symptoms might look different at older ages. For example, in adults, hyperactivity may appear as extreme restlessness or wearing others out with their activity. For more information about diagnosis and treatment throughout the lifespan, please visit the websites of the National Resource Center on ADHDexternal icon and the National Institutes of Mental Healthexternal icon. Criteria for Diagnosing GAD When assessing for GAD, clinical professionals are looking for the following: The presence of excessive anxiety and worry about a variety of topics, events, or activities. Worry occurs more often than not for at least six months and is clearly excessive. The worry is experienced as very challenging to control. The worry in both adults and children may easily shift from one topic to another. The anxiety and worry are accompanied by at least three of the following physical or cognitive symptoms (In children, only one of these symptoms is necessary for a diagnosis of GAD): Edginess or restlessness Tiring easily; more fatigued than usual Impaired concentration or feeling as though the mind goes blank Irritability (which may or may not be observable to others) Increased muscle aches or soreness Difficulty sleeping (due to trouble falling asleep or staying asleep, restlessness at night, or unsatisfying sleep) Excessive worry means worrying even when there is no specific threat present or in a manner that is disproportionate to the actual risk.3 Someone struggling with GAD experiences a high percentage of their waking hours worrying about something. The worry may be accompanied by reassurance-seeking from others.4   In adults, the worry can be about job responsibilities or performance, one’s own health or the health of family members, financial matters, and other everyday, typical life circumstances. In children, the worry is more likely to be about their abilities or the quality of their performance (for example, in school).5 Many people with GAD also experience symptoms such as sweating, nausea, or diarrhea.6   The anxiety, worry, and other associated symptoms make it hard to carry out day-to-day activities and responsibilities. They may cause problems in relationships, at work, or in other important areas of life.7   In order to give a diagnosis of GAD, these symptoms also must be unrelated to any other medical conditions and cannot be explained by a different mental disorder or by the effect of substance use, including prescription medication, alcohol, or recreational drugs.8   What is Depression? Depression, otherwise known as major depressive disorder or clinical depression, is a common and serious mood disorder. Those who suffer from depression experience persistent feelings of sadness and hopelessness and lose interest in activities they once enjoyed. Aside from the emotional problems caused by depression, individuals can also present with a physical symptom such as chronic pain or digestive issues. To be diagnosed with depression, symptoms must be present for at least two weeks. Depression DSM-5 Diagnostic Criteria The DSM-5 outlines the following criterion to make a diagnosis of depression. The individual must be experiencing five or more symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure. Depressed mood most of the day, nearly every day. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day. Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down). Fatigue or loss of energy nearly every day. Feelings of worthlessness or excessive or inappropriate guilt nearly every day. Diminished ability to think or concentrate, or indecisiveness, nearly every day. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. To receive a diagnosis of depression, these symptoms must cause the individual clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms must also not be a result of substance abuse or another medical condition.
(LPC, NCC, CEDS-S)
Answered on 10/21/2021

I have adhd but I feel like I also might be social anxious as well?

It's entirely possible that anxiety occurs much more frequently in people with ADHD than they do in the general population due to the nature of both. On the surface, Social Anxiety and Attention Deficit Hyperactivity Disorder can sometimes look alike. The following are just a few ways symptoms of Attention Deficit Hyperactivity Disorder and Social Anxiety overlap: Difficulty socializing: People with Social Anxiety may struggle to make and maintain friendships due to fears about rejection. Someone with Attention Deficit Hyperactivity Disorder is likely to have low impulse control and trouble picking up on social cues, making it difficult to sustain friendships. Inattention: A person with Social Anxiety Disorder may seem tuned out, but they are really just distracted by worries. Those with Attention Deficit Hyperactivity Disorder are inattentive because of differences in the brain that affect focus. Trouble completing tasks: People with Social Anxiety might become stuck on a task and be too anxious to ask for help. Those with Attention Deficit Hyperactivity Disorder might not turn in an assignment because of poor planning skills and forgetfulness. A big place where these two interconnect, and subsequently where healing begins, is in focus. One of the reasons why focus is such a big deal in both of these two and why they can be a challenge to overcome is rooted in where their mind is. Attention Deficit Hyperactivity is punctuated by the inability to focus, and Social Anxiety is focusing on the future or the past in social situations—or both. So, if you are socially anxious, then Attention Deficit Disorder can reinforce this tendency to live in those time frames as opposed to the now and focusing on what you want to do as opposed to what could happen. One of the roots of the problem with social anxiety is something we call "safety mode," a way of being in social settings that can put up obstacles to what is really important to you in your life. Safety mode is about living out of harm's way, about safeguarding yourself from social danger. The social danger is what you are scared might happen in a social situation. Now, in order to keep yourself safe from those results, there are four main things that you probably do: use safety behaviors, focus on social danger, resist anxious feelings, and buy into anxious thoughts. 1. Using safety behaviors: These are the things you do to protect yourself from social danger, including outright avoidance or staying away from social situations. In addition to outright avoidance, there are many other types of safety behaviors. These are behaviors that come into play once you are in a social situation. They are geared to minimize your chances of being scrutinized and judged, by hiding your anxiety symptoms, keeping you as inconspicuous as possible, and attempting to control the impression you are making. 2. Focus on Social Danger: This involves paying attention to the things you are most concerned about. Self/internal focus: For some people, those are the more visible physical symptoms of anxiety, such as blushing, sweating, or trembling. For other people, it's what they're doing (e.g. moving awkwardly, spilling a drink) or what they're saying (e.g. something boring). It can be any aspect of yourself that you think will influence how you are coming across to others. External focus: You might also lookout for signs that people are scrutinizing you (e.g. staring at you) or disapproving of you (e.g. frowning at you, turning away, or appearing to be disinterested). 3. Resist Anxious Feelings: Anxious feelings consist of the basic emotion of fear and the physical sensations that go along with it, such as palpitations and muscle tension (& those we just talked about that you focus on). Most people who are socially anxious are not OK with feeling that way. They not only focus on anxious feelings, but also resist, struggle with, and try to control fear. That's often where safety behaviors come into play. 4. Buy into Anxious Thoughts: This is how are you relate to the thoughts, getting caught up in them, buying into them, and doing what they are telling you. We call that being fused with your thoughts. Focusing on danger, resisting anxious feelings, and buying into anxious thoughts all work together like a team to feed your safety behaviors. A great place to start with overcoming these challenges is developing mindfulness and relaxation exercises when you are not in a social situation. You don’t train for a marathon while running it, and the same thing applies here—the key is to begin to practice BEFORE your in a social situation, not while you are in it. Beginning a mindful lifestyle on a daily basis now can help you start the process of letting go of social anxiety, and the various things that go along with it – negative intrusive thoughts, catastrophizing, time-traveling, and ruminating. That activity and developing the mind-body connection can really start the process. 
(MS, LPC-MHSP, CCTSI)
Answered on 10/21/2021

Motivation/Concentration

Hi Chloe,   I’m going to give you a two-part response to your question because there are two main issues to address here. One involves whether the symptoms you are currently experiencing could be due to something else besides ADHD, because it would be highly unusual for ADHD to suddenly “show up” in adulthood in someone with no prior history. Second, I will talk about ways to manage ADHD-like symptoms. Because the fact is that anyone who is struggling with lack of focus, difficulty staying on task, or feeling mentally scattered can benefit from techniques that work for those who do have ADHD. So it is not a matter of figuring it out for sure or coming to a definite conclusion about whether you meet the full criteria for the diagnosis or not. You can apply the same tools that specialists recommend and that people with ADHD have found helpful in their efforts to gain focus.   Okay, so first I want to ask you to reflect on recent events or changes in your life. Have you had any major losses in the past few months? This could be the death or illness of a loved one, your own health issue, a break-up, job loss, or move. It could even be a positive life event such as marriage, becoming a parent, or getting a promotion at work. Even just the ongoing impact of life during this Covid time has many people feeling not quite like themselves, even now when life is starting to return to “normal.” I ask this because difficulty with focus and concentration can result when we are adjusting to a whole host of life events. Grief, for example. If you ask most people to list the symptoms of grieving a loss, the list is likely to include sadness, crying, lack of energy, and possibly angry outbursts or irritability with others. And all of these are definitely part of it. However, if you ask members of a grief and loss support group what has most surprised them about their experience, you will commonly hear them say things like, “I feel like I’m going crazy,” “I keep forgetting things,” and “I can’t focus on anything.” They sound bewildered as they ask, “How could my grief over losing a loved one possibly explain why I have lost my keys three times in the past week/how I forgot to pick up my child after soccer practice/the silly mistakes I keep making at work?” While this is genuinely baffling to people when they experience it for the first time, any grief counselor will tell you that they hear these questions every day. The explanation is that adjusting to any major life change requires mental and emotional energy. When your brain is processing a life-changing event, it can’t be expected to juggle everything perfectly, keeping all the balls in the air like it usually does. So before you assume that it is ADHD you are dealing with, consider whether your symptoms could be better explained by looking at the emotional load you are carrying. Fortunately, these symptoms do subside over time; most people return to their normal level of functioning gradually over the months following the loss or change.   Next question to reflect on: How has your general mood been lately? If you have been having symptoms of depressed mood (sadness, feelings of worthlessness, lack of pleasure in activities you previously enjoyed, or difficulty eating and/or sleeping) it would not be surprising that difficulty with focus is also on that list. If you suspect that this might be the case, I highly recommend that you discuss your symptoms with your primary care doctor and begin therapy. Depression is treatable, and the sooner you take active steps to counter it the better your prognosis for a full recovery.   You describe that you begin a task, lose focus, and move on to something else before getting anything done. This state of mind can be called “scattered” or “fragmented,” as people often describe it as difficulty pulling all of the “pieces” of themselves together.   I notice that you mention motivation in your question, in addition to difficulty with concentration. It might be helpful for you to reflect on the connection between those two things. What usually comes first – difficulty with motivation or concentration? In other words, do you struggle to get started with a task, and then lose focus once you’ve started? Or does your motivation start out strong and wane as you continually try to direct your energy and run into roadblocks?   When it comes to actually address these challenges, fortunately, there are a wealth of resources out there, ways that you can modify your behavior and environment to better harness your energy and apply it to one task at a time. The ones I recommend most often are:   ·        Using a timer – commit to sticking with one task for a set period of time (no more than ten or twenty minutes) and then take a break, or divide your time between tasks in a methodical and organized way rather than the haphazard way that leaves things undone.   ·      Make lists, keep them accessible at all times, and check them throughout the day   ·      Reduce potential distractions with noise-canceling headphones or a “white noise” machine or app.   ·      Develop a system for keeping your work area organized, as outer order contributes to a calmer and more centered state of mind.   This website has many more tips and suggestions:   https://www.additudemag.com/category/manage-adhd-life/   It sounds like you plan to pursue individual therapy, and I am pleased to hear that. Having a safe place to explore the different aspects of your life and how they fit together can allow you to gain clarity about what the underlying problem is. Then you and your therapist can work together on a plan to address your challenges in a proactive way. If difficulty with focus and concentration persists, you might want to consult with a psychiatrist to be evaluated for ADHD and explore other treatment options.   Thank you for the opportunity to answer this question, and I wish you the best.   Julie    
(LCSW)
Answered on 10/21/2021

How do I deal with feeling of anxiety due to ADHD type symtoms?

Dear Jack,   Thanks so much for writing to Better Help with your question about anxiety and difficulties in relation to concentration and focus. You shared in your post that many of the symptoms that you have been experiencing are similar to those of ADHD symptoms. Have you ever visited with a medical doctor or psychiatrist for a more formal evaluation and diagnosis of your symptoms? Have you ever tried any form of medication in the past? Was it helpful or not? My advice would be to visit with a psychiatrist or a medical doctor who specializes in ADHD related disorders to gain a more formal evaluation of your symptoms and what you are going through.   You shared that a lot of the symptoms that you are experiencing started in your childhood. When you were a child, were you ever evaluated for any form of learning disability or ADHD? How did you do in school growing up? What were your strengths and what did you struggle with in school?   I think that gaining a more formal diagnosis and assessment from a medical professional can hopefully give you some more information and hopefully answers for what you are dealing with.    It certainly sounds like you have already been doing a lot to try and help with your symptoms. I encourage you to continue with those practices as they can be extremely helpful, including meditation, taking breaks during work, making to do lists, etc.   There are many methods for staying organized and focused at work and within one's personal life. I will provide some additional options or ideas to assist, but I do strongly encourage you to also seek the opinions of a medical professional.   1. Organize your work space in a manner that works best for you. Visit your local office supplies store to purchase some supplies including filing folders, shelves, white boards, etc. Utilize these tools and supplies in a manner that works best for you.   2. Utilize a planner - either digital or on paper - to keep track of events, reminders, upcoming events, etc. 3. Keep specific places for things that you use often including keys, wallet, phone, etc. Make it a practice to keep those items in the same exact place no matter way. For example, purchase a key hook and make it a habit to use it.    4. When you have larger tasks to complete, create a breakdown of the various tasks involved along with a timeline for these tasks. when faced with large tasks, it can certainly be helpful to see these tasks broken down into specific parts.   I hope that you found this information helpful. Please let me know if you have any additional questions. Thank you! 
(Ed.S., M.C., L.P.C.)
Answered on 10/21/2021

What are my best resources to be screened for ADHD?

I am so sorry to hear that you are struggling right now with ADHD-related symptoms. Therapy can be a great resource to try first and then medication can also be helpful. It will be important to recognize when your feelings have a purpose versus when they do not.  We of course want positive feelings in our lives, but sometimes negative feelings are there for a reason and we need to live out that purpose in order for it to get better.  If we do not live out the purpose of our feelings, it likely leads us to feel worse.  For example, something as simple as having anxiety about needing to get the chores done has the purpose of getting us motivated to get the chores done.  Therefore, if we do not live out that purpose and the chores remain undone, that can lead to more bad feelings, such as, “I am lazy” or “I am worthless.”  This is a simple example of how if we do not pay attention to our feelings and live out the purpose, they can become much, much worse.  So, I would encourage you to try and separate out the thoughts that have a purpose from the thoughts that do not have a purpose and are more intrusive.    For the ones that do have a purpose, it can be helpful to allow yourself to think through the anxious thoughts because anxiety has a nasty way of going to the worst possible scenario.  If you can wrap your head around that scenario, it can make it less scary.  For example, I had a client that was very anxious daily about being single for the rest of his life.  Thinking to that extreme is clearly anxiety and it just lingers there.  So, then he was able to think through that scenario and come up with a plan to make it less scary.  He then came up with that if he really is going to be single the rest of his life, which is highly unlikely, he is going to work towards being able to live close to the ocean since that is a dream of his.  Thinking about it now does not make him as scared because he recognizes he could be happy with that. So, try to think through specific things you are anxious about that have a purpose and make sure you have a specific plan on how to improve those things. For example, having a specific plan for how to address specific environments where it is hard to focus. Adding structure will be the best thing that you can do even if it seems like a lot of structure.     Intrusive thoughts tend to not have a purpose and it can be really helpful to try and overpower those before they are accepted as truths.   We can have power over our thoughts and I want to help you not engage in these thoughts that make you so upset.  The easiest example of this that I can think of is if I went skydiving.  If I went skydiving I would have some obvious, rational, anxious thoughts.  If I really have a desire to skydive though I will need to not engage in those thoughts.  I might have thoughts such as, "My parachute could fail, I will hit the ground, I am going to pass out, etc."  However, since I really want to follow through with skydiving, I would want to stop those thoughts in their tracks with, "I know this is going to be really fun, they inspect the parachutes ahead of time, people hardly ever get hurt doing this, etc."  By focusing on those thoughts and not engaging in the others, I would be able to follow through with skydiving. Try to sort through any thoughts that get you down about yourself and that you can’t handle all of this and try to overpower those.  These types of thoughts are very common when dealing with down focus issues like you described.       As you do those processes it can be helpful to validate yourself as someone of worth and someone that has been able to get through the stress and focus issues in the past. Something that could be helpful for you is what I like to call centering thoughts.  These are thoughts that are predetermined and unique to you for you to turn to in low moments.  They need to be powerful enough to bring you back to your center.  It is important that these thoughts are accessible for you to look at when you need to.  Some clients prefer to read and re-read them and some prefer to write and re-write them until they feel better.  I have clients that write these somewhere they will see daily such as their bathroom mirror or phone background, while others simply have them in their phone to pull out when they need to.  An example of a centering thought would be from a client I had that related to nautical-themed things and her thought was, "I will not let this sink me."  Another example is from an Olympic skier that actually had difficulties with negative thinking getting in the way of her performance so she went to therapy.  She mentioned that she learned about centering thoughts to battle all of the people telling her she “should be” or “should do.”  To battle those thoughts, she uses the simple centering thought of, “I am.”  She can then remind herself that she is good enough, that she is confident, and that she does want to still compete, which really affirms her own feelings and not others.  Hopefully, you can come up with something that helps validate your abilities to move forward as you challenge your focus.      I hope that some of this is helpful and that you can apply it to your circumstances.  I hope that you can lean on some family and/or friends through this.  Doing so can help take the weight off of your shoulders as well as hopefully get some valuable advice from them. Try to take the healing one day at a time and adding one positive thing back into your life each day. I wish you all the best and I hope that you are staying safe.
(MA, LPC, NCC)
Answered on 10/21/2021