An ADHD diagnosis often answers some big, life-long questions. Then, it quickly raises new ones: What exactly does this mean? What are our options? Where do we go from here?
ADDitude surveyed its community about the important questions you want, and need, answered after you or your child receives an ADHD diagnosis. We asked experts to provide insights and advice to clear up confusion and illuminate a clear path forward.
1. Who is best suited to treat ADHD, and how do I find a qualified professional?
This is the most common question parents and adults ask. It is a reflection of how few experienced ADHD clinicians there are in the world. A survey done at the Mayo Clinic about eight years ago found that the average parents of children with ADHD consulted 11 clinicians before they found one they thought was well prepared.
For a good outcome, ADHD medication and counseling will both be needed. Medications level the neurological playing field so that the person with ADHD has the same attention span, impulse control, and level of arousal as anyone else. The professionals licensed to prescribe controlled substances vary by state. Physicians and nurse practitioners almost always have this authority. Some states also include physician assistants. But you can’t stop at just medication. The work of helping the whole family learn about ADHD, and helping the person with ADHD deal with the emotional aspect, can be done by psychologists, counselors, coaches, and other professionals.
In short, there is no particular specialty or advanced degree that is intrinsically better able to diagnose and treat ADHD. You are looking for someone who wants to treat ADHD — someone who has been willing to put in thousands of hours of her own time to become skilled at it. How do you find one of these rare clinicians?
Start by asking friends, family members, parents of your child’s classmates, and members of nearby CHADD or ADDA support groups who they go to and whether they are happy with the care they are receiving.
Speak to your shortlist of recommended clinicians and ask: How long have you been working with patients with ADHD? What percentage of your patients have ADHD? Have you received any training in the diagnosis or treatment of ADHD? What is involved in the diagnosis—written tests/interviews? Your typical treatment plan — behavior modification, medication, alternative therapies? What are the costs involved? Do you accept my insurance?
Be willing to travel to get the initial evaluation from an expert in ADHD. Many can put you in touch with a provider closer to home for recommended services. — William Dodson, M.D
2. Why wasn’t my ADHD diagnosed earlier?
ADHD is no longer considered a “childhood” diagnosis. Since 2014, more adults have been diagnosed with ADHD than children or adolescents. The average age at diagnosis is now in the early 30s. This evolution is due to a number of reasons.
When you’re sad, mad, frustrated…, it can be hard to tell what will make you feel better. Maybe you want someone who will just listen without being too nosy, or you might tell yourself distractions like ice cream or TV will soothe, but sometimes, what we really need is time alone to write. This article gives you some tips on how to use writing as a self-care tool.
Throughout my life, I have often used writing as a tool to work through difficulties, make better decisions, and express myself more fully and honestly than I could talking in person.
Shrek was right! People are like onions, covered under layers of expectations, fears, past traumas, pretenses… The act of writing thoughts down is beneficial for a few reasons beyond just getting our thoughts out. When we write our thoughts and feelings down on paper, it gives us a chance to pause and creates the necessary distance to uncover what we are actually feeling, making it easier to identify the root of issues. Logical fallacies and hurried conclusions reveal themselves as we put ink to them.
Many think of writing as a chore—something they struggle to do for school/work—but when you journal-write for yourself, it’s therapeutic, rewarding and insightful. Journaling is a way to get in touch with your thoughts, feelings, and struggles without the fear of judgement.
There is an old saying that says, “you cannot see the world for what it is, only for what you are.” It means that our actions are responses to how we perceive the world. The stories we tell ourselves every day have a huge impact on our lives. These internal dialogues are like what soundtracks are for movies. You might just overlook the soundtracks as unimportant background noises until you find that It’s hard to laugh in even the best comedies when you pair them with suspenseful horror movie soundtracks. When we write, we explore these stories, discover blindspots, and are given the opportunity to start re-writing past wrongs and planning for a different life outcome. What soundtrack does the movie of your life play?
It’s important to pay attention to what is happening in your life and not just keep it all in. Writing about what happened can help you process it better, which is why many psychologists have started recommending journaling as an effective stress relief technique for patients who don’t want to take medication or participate in talk therapy. Journaling demands that you think deeply about your life and experiences. For some, journaling is a way to talk about their anxiety or depression, while for others it is a way to process trauma or abuse they have had in their past.
The psychological benefits of writing include self-exploration, emotional release, stress reduction, pain distraction, physical healing and much more. A study was done at Stanford University on patients who were admitted into the hospital for cancer treatments. The studies found that those who wrote every day for two or more hours had better outcomes than those who did not write anything at all. Other research found that writing about traumatic events can lessen the intensity of negative thoughts and feelings about the event in the long term.
Writing therapy is not only a great way to express your thoughts and feelings, it can also help pinpoint things that you need to work on. Sometimes it can be used as an emotional outlet for memories or feelings too difficult to talk about. People often feel safer when they write about their thoughts and feelings in private, which can make it easier for them to explore their deepest emotions without fear that someone will reject them or judge them negatively.
Journaling is a way to shape your life the way you want it. It gives you a chance to rewrite your life’s story and make it better. It can help us express ourselves better, process what has happened in our lives more clearly, find inspiration for the future, or unburden ourselves from the things that weigh us down.Journaling is also an opportunity to shift perspective by stepping outside of ourselves. The guided journal prompts from curaFUN help you gain a broader perspective on things you have experienced and open up new ways of thinking about them. It can also help you identify patterns in your life which might not be readily apparent otherwise.
Writing therapy has been clinically proven to improve one’s mental wellbeing. curaFUN’s Quest Depot integrates guided journal, emotional awareness, goal setting, progress tracking and reward/motivation system all in one visual interface that leverages positive social influence, gamification and psychology. In place of the daunting blank journal page, users selects their current mood emoji and then write or speak (speech to text) their responses to journal prompts.
If you want to start journaling on your own, below are some ideas to get you started.
The WDEP model
A four-step process that can help you think about what you want to achieve, and how to go about it.
● Wants. What do you want?
This might be something like “I’d like to start my own business” or “I need more time for myself”.
● Doing. What are you doing to get what you want?
You can also make a list of things that might help you get closer to your goal. For example, these might include taking on extra work, finding a new job, or hiring an assistant.
● Evaluate. Is what you are doing helping you get to what you want?
● Plan. Can you make a more effective plan to get what you want?
Evaluate how successful you are after trying this method and plan accordingly for future obstacles.
This is the basis of behavior therapy. It replicates the natural process of learning and understanding of human behavior, which starts with an event or antecedent that leads to a behavior or belief, which in turn leads to a consequence.A: Activating event or antecedent
B: Beliefs and thoughts about this event; what we tell ourselves about it
C: Emotions and subsequent actions that result from this belief system
Though the therapeutic benefits of writing are undeniable, it is important to note that it is not always a replacement for therapy. Journaling can, however, help us become more emotionally aware and process negative events which have happened in our lives. For many, it is a way to help them feel safe in this scary world.
Writing is always free, private and available. So start journaling to take care of yourself!
Imagine a treatment that could manage the behavior of a child with attention deficit disorder ( ADHD or ADD ), make you a better parent, and enlist teachers to help him do well in school — all without the side effects of ADHD medications. There is such a treatment. […]
Creativity does not rest on eureka moments; it is a process, designed to consistently bring abstract ideas into the tangible world.
For creatives, this emphasizes the importance of routines. Random bits of profound inspiration are few and fleeting; consistent work in your craft requires a sustainable way to develop good ideas into great ones. Recall the wise words from Chuck Close: “Amateurs sit and wait for inspiration, the rest of us just show up and go to work.”
Perhaps one of the best ways to improve your own processes is to study the masters. Thanks to books like Daily Rituals, our desire to see what “go to work” means — by getting a peek into regular routines — has been thoroughly satiated.
Though the output of these geniuses is often intimidating, how they conduct their work is often surprisingly easy to relate to. One such person I took inspiration from was Ludwig van Beethoven.
The Woods Are Lovely, Dark & Deep
Beethoven kept his creative promises by strategically using his time to incubate ideas. His favorite method of thinking things through? Long, solitary walks through the forested valleys of Vienna.
He placed great importance on this planned time for reflection and idea evaluation. It appears he wasn’t alone; notable craftsman the world over share similar sentiments on the utility of breaking up their day with walks.
Beethoven went for a vigorous walk after lunch, and he always carried a pencil and a couple of sheets of paper in his pocket, to record chance musical thoughts.
Gustav Mahler followed much the same routine — he would take a three- or four-hour walk after lunch, stopping to jot down ideas in his notebook. Benjamin Britten said that his afternoon walks were “where I plan out what I’m going to write in the next period at my desk.”
Recently, psychologists took an interesting step (or two) forward in understanding the creative benefits of walking. Stanford study was able to show that walking helped subjects produce more novel ideas and enhanced creative thinking during the walk and immediately after, compared to sitting.
As the title of the study so humorously points out, walking may be the missing ingredient to consistently give your new ideas some legs. There are a few reasons why walking is genuinely useful to the creative process:
The fact that walking is exercise. It has been well established that exercise is beneficial for thinking creatively. The key seems to be that exercise consistently improves one’s mood, and further studies on creativity show that working during a strong mood (especially a positive mood) will result in more novel ideas. Although walking isn’t strenuous, it is certainly better than being hunched over in a chair.
Allowing time to re-conceptualize. Notice how Beethoven and others used their walks as breaks. They didn’t start their day with incubation, they included it to break up an earlier work session where they had already put thought into a project. Eureka moments will remain illusive if the work isn’t done first: “In general, creativity seems to come when insight is combined with the hard work of analytical processing.”
A separation of stimuli. The use of stimulus control to change behavior is nothing new (often used by Dr. BJ Fogg, discussed here). But what if a strict association of external stimuli could help with creativity? Walks help create divide between a work environment and a thinking environment. Engaging in both at your desk makes it a nebulous location where too many things happen at once.
In particular, the second and third points deserve a more thorough investigation. Let’s begin with why the separation of inspiration and execution seems to be a necessary part of the creative process.
Absorb State vs. Synthesis State
Given the often muddy nature of creativity, it is an understatement to say that I’ve greatly enjoyed the practical, down-to-earth advice from Harvard psychologist Dr. Shelly Carson.
In her book Your Creative Brain, Dr. Carson highlights the importance of using strict boundaries between your absorb state (taking in and evaluating information) and your synthesis state (when you execute on your ideas). Her research has led her to believe that this is potentially the biggest roadblock to being consistently creative:
Everyone has a built-in censoring system in their brains that filters thoughts, images, and memories, and stimuli from the outside world before they reach conscious awareness.
Learning to loosen up this mental filtering system to allow more novel ideas and stimuli into conscious awareness is one of the biggest challenges for people who don’t think of themselves as creative.
She’s published research that shows how those capable of high creative achievement are benefited from a lower “latent inhibition,” meaning they are less likely to ignore seemingly irrelevant stimuli. They absorb what others would filter out; whereas most people see a red wheelbarrow, some people see a Red Wheelbarrow.
Put another way, the absorb state is when you are open (playful thinking) to new ideas, and the synthesis state is when you are closed (logical thinking) in order to execute. Creating a clear boundary makes your creative process more consistent, by allowing you to schedule a system around creating rather than relying on serendipity.
Notice how this closely relates to the divide that walking creates. One might argue that a regular walk through Vienna’s woods was Beethoven’s preferred time to be open to new ideas; his scheduled hour for an absorb state to freely go down the rabbit hole.
Walking separates these two states of the creative process. It allows time to expand on what you’ve already worked on, and removes you from work so you can think clearly.
For the lay man, this creates a convincing argument that trying to force the entire process to occur at your desk is a mistake. Separating work from consumption and incubation becomes far easier when the locations are different.
Perhaps it is time to quit your desk and do your best thinking somewhere else.
Winnie, a beautiful, musical, and timid African Grey who was apprehensive about people but loving once you gain her trust came to us last year from a local non-profit rescue, Parrot Education & Adoption Center, as a foster. She picked up Mozart’s Queen of the Night after hearing it just twice and improved my coloratura game immensely with her clear resonance and astounding range. Winnie was tech savvy and racked up on my electricity bill by talking to our Alexa devices constantly.
Unfortunately, she was also an anxious creature who plucked constantly—to the point that she has NO tail, and my goal as a PEAC foster was to rehabilitate her for adoption, but I made it a personal goal to re-feather her. With years of experience rehabilitating feral cats otherwise doomed for euthanasia and a go-to foster for pregnant cats at Helen Woodward Animal Center, I saw this as the next-level challenge in animal behavior science.
Whereas dogs and cats have been domesticated for thousands of years, any pet parrot today is only two generations from their wild, free-flying ancestors. For survival, they’re designed to communicate with their flock loudly and clearly even through a dense rain forest. They also chew, bite, scratch to prevent their beaks and nails from growing unsafely long. Sadly, many of these natural instincts lead to pet parrots’ abandonment.
Birds are often recognized for their remarkable cognitive ability. Einstein, the most researched parrot to date, demonstrated his species’ contextual understanding of language when he wasn’t taught the vocabulary “banana” but requested a “long, yellow fruit” from his caretaker, creatively using the vocabularies he was taught in completely different context and combination. This level of intelligence demands to be utilized, so when parrots are locked up in a cage all day, unstimulated, with nothing to do, they WILL find something to do. They will pluck their own feathers, pick their skin, and scream for attention. In behavior therapy terms, those are just maladaptive behaviors, undesirable coping skills that need to be replaced with positive ones just like tantrums and bullying in children.
Change is hard, and change is slow. In the first of our 12-Step Make It Happen series, I discussed the power of consistency. In the context of feather plucking in parrots, animal behaviorists recommend out-of-cage human interaction time, proper amount of sun and sleep and foraging activities so parrots must keep their minds and bodies active and work for their food.
Correct and Consistent Implementation Leads to Success
When I cared for a newborn litter of 5 kittens who were just learning to use the litter box, there was a lot of cleaning. But it was nothing compared to the proper caregiving of parrots, and Winnie covered my house with thrown out food, droppings, feathers and skin flakes that she’s picked.
But I continued offering different enrichment and foraging activities to replace her feather plucking and was the proudest foster bird mom when a ruby red feather sprang up on her tail. Winnie was successfully adopted during the early days of COVID quarantine through PEAC, and I was very proud to have been a part of the process. Winnie has and will continue to bring her new family love and beautiful music.
Why isn’t it working?
Towards Christmas last year, another foster bird came to us. It’s been three decades since I’ve had
smaller birds, and I fell in love with Zorro the moment I saw him. He looked like a stuffed doll with a white sweater and stepped up to cuddle with me the first time we met. Zorro wanted to cuddle and be on people 24/7. He also wanted to eat human table food (very unhealthy or even deadly for parrots), and was used to getting his way–Zorro obstinately screeched at a high pitch whenever he didn’t. Does this sound like a child throwing a public tantrum when his parents refuse to buy a bag of candy for breakfast?
Despite his size, he was very aggressive and territorial towards our family parrot, and to my shock, he started feather plucking. Zorro slowly untangled his fluffy white sweater feather by feather. Did I cause or somehow instigate the feather plucking? Did I not love him enough? I did all the right things. How could this be happening? Does this make me a bad foster parent?
Parents often have similar trains of thoughts about their children. Did my parenting cause my son’s ADHD? Is my daughter under-performing in school just to spite me? Or as parents, we attack each other rather than focus on what should be our goal—raising children to be the best versions of themselves.
I started fostering rescued animals because I love them. Their love is so simple and unconditional. They didn’t choose to be purchased as pets and live in captivity with us. So, if my focus remains on the goal of getting animals adopted, then I need to consistently do what works to help them. For Zorro, I needed to observe how he’s feeling through his behaviors, and explore all possibilities of what might be prompting him to pluck. Sometimes the answer is as simple as not getting enough sleep. Other times, the determining factors are less within our control, like hormones, puberty.
Behaviors are often the guidebook to children’s true feelings. For example, they may be nervous about going to a new school because they haven’t been taught how to initiate and maintain conversations comfortably with new people, so they cry and feign illness to avoid going to that new school. Parents can play the curious detective to find out the root causes of their children’s behaviors, empower them by building in areas where skills are deficit, and in the process, build stronger and closer relationships with their kids. I hope the parallels drawn to my parrot fostering experience help highlight some common fallacies.
As you now see, we’ve returned to our “12-Step Make It Happen” theme. Below is a bullet point summary of the steps discussed so far.
Consistency – Disciplined practice
Self-Awareness – Honest observation without judgement
Exploration – Reflect, Troubleshoot
Parrot Education & Adoption Center (PEAC) is a 501(c)(3) non-profit, volunteer organization dedicated to educating current and potential bird owners on the proper care of companion parrots. They have interesting and practical classes that teach people on parrot behavior and how to make engaging toys and activities for companion parrots. Click here to view the birds available for adoption.
Imagine it was 1848, and you found the biggest gold mine, and told everyone about it. You were right—the motherload of gold was there, but you never carry through and took any action. Instead of living the rest of your life covered in gold, you watched people who heard about your discovery do the hard work and carry off with the gold.
Good ideas pave the grounds of startup cemetery and failed new year resolutions. Dreams and ideas are wonderful, but they have no value and can sometimes seem to be only figments of our imagination if we don’t take action. The real magic is in making them happen.
But is there really magic?
Successful implementation makes dreams come true, it isn’t very complicated (not to say that it’s not hard).
Over the next few weeks, I’ll be covering a 12-step process to making it happen. This process works for any goal—wealth, parenting goals, behavior change, weight loss, you name it.
These 12 steps put your success on autopilot. If you’re doing the right things each day, good things happen.
Step 1: Practice Consistency
Consistency doesn’t guarantee results, but it multiplies your effort and accelerate results. When you first start doing anything, it’s awkward and you want to quit to put an end to that mild discomfort. But if you stop, it’ll always be awkward and hard. When you’re consistent, whether it’s with math practice, public speaking, working out, taking StrengthBuilder, you build muscle memory and reduce internal resistance,
Consistency takes practice, and it builds your faith in yourself and discipline, which is a requirement for success in any area. What you do consistently, everyday matters more than what you plan to accomplish.
What about my goals, you ask? I’m going to get to goal setting in a future post. Setting a goal that is right for you and attainable is very important, but it’s what most people already love to do. It’s fun and oh-so-tempting to chase the next great idea, shop for goals and jump from one thing to the next Chasing keeps you busy which our brains often perceived as productive, but it doesn’t get you to the finish line. We start with consistency or self-discipline because it is a prerequisite for any goal you choose.
The Mini Consistency Challenge:
Consistency takes discipline, and both are strengths that you can intentionally build and fortify Practice first on a goal that is realistic to make it easier for you to follow this process before tackling more difficult ones.
1. Assess and Measure your progress.
Performance experts say that “When you measure something, the thing you measure changes.” Just by monitoring your progress, you’re likely to see more improvement. Whether it’s a chore or a goal, you can use a tracker to monitor it—it’s proof that what you’re working on is important.
This is why our StrengthBuilder programs have assessment questions discreetly built into the game portion six or seven times throughout the program.
2. Support Your Journey
Set reminders of your goal for yourself in places and times when you’re likely to see them. Leave notes, signs, and any other type of reminder to ensure you remember to take action each day. In my house, we have reminders on whiteboards, calendars, Amazon Alexa devices. I’ve tried different reward charts, responsibility apps for years with my kids to get new habits to stick. Many of them failed because as a parent who’s supervising the system, I wasn’t consistent!
The Coming of Mad Dash
Almost every night, I would drag myself to get my kids to put their stuff away, prepare for the next day. It was repetitive and exhausting for me. Nothing worked until I laid out our “Mad Dash” plan where I schedule our speakers to play a Mad Dash music list for exactly 15 minutes at the exact same time everyday where everyone drops what they’re doing and starts cleaning like “mad” until the music is over.
Set Up For Success
The saying “an ounce of prevention is worth more than a pound of cure” is so true. Discipline is difficult, so do anything you can to limit temptations. When you’re assessing your progress, make sure to investigate where problems tend to occur. Are you distracted by the TV or internet? If so, do your work where these distractions aren’t present. Are you less likely to be compliant in the evenings? Then, get your work done in the morning.
In the beginning, there would be days when a movie or game on their iPad would tempt them to skip Mad Dash. To problem solve and set up for success, we started to schedule our family movie night to end before our Mad Dash time. Going a step further, I scheduled for wifi to be turned off during Mad Dash time. It made being disciplined about our family Mad Dash much easier when my kids didn’t have to resist Netflix. I simply took that option away.
Many cite a Maltz study that it takes 21 days to form a habit. James Clear, the author of Atomic Habits, talks about the different research and there is sufficient evidence that it may take as long as 254 days to securely form a new habit. This is why all of curaFUN’s programs are deeply discounted for children who sign up for an entire year. Learning new skills, forming new habits are hard and they take time. It’s human nature to fall off track, so having a support system to spot it and remediate is critical.
p.s. We had Flo Rida’s My House playing in our Mad Dash playlist for more than a year before finally switching it out, and even years later, I feel the urge the “mad dash” and vacuum every time I hear the song.