Stuff that helps (and doesn’t) ADHD, from someone with ADHD

For no reason in particular, I felt like sharing some tools and methods that I’ve tried since my ADHD diagnosis and how they’ve gone.

Things that help and are (comparatively) easy:

• Slowly building a morning routine. I really think your morning and how prepared you are for your day at the end of your morning routine has a huge potential to shape your day. Building habits is much more difficult for us than the general population, and it’s harder than we give it credit for ourselves. The best thing I’ve found is to build it piece by piece, and not even considering adding more pieces until the existing ones are no longer an energy drain. Once they feel completely natural, you can build. Brushing your teeth and taking your meds should be at the top of the list. From there I added a set time to eat and a skin-care routine. Once those are established, I want to work on journaling and exercise. Go as slow as the situation requires, and don’t feel anything about the stuff that you want to add on to it until it’s time.

• Breathing exercises when you’re overloaded. This is one of those things that caught me completely off-guard with how effective it can be. At any point in your day you can do this, even during meetings, because it’s pretty invisible. You can google “breathing exercise” and Google will pop one up for you: six seconds in, six seconds out, repeat five times. One minute elapsed and I’ve seen my heart rate drop 20-30bpm in that period. I’m not a fan of the “box breathing” technique where you hold your breath for some amount of time, it seems to add more stress than it takes away. You can also do a YouTube search for “take five mindfulness” and get a result by Cory Muscara of a related exercise that takes 30 seconds to a minute but adds in a tactile sensation that may or may not help you, but it’s a cheap test right?

• Figure out your hydration for the day before you sit down to start work. I’ve been on an iced green tea kick lately, and I fill up a 30 oz. cup of it before I get seated. I’ve also got one of those comically large half-gallon water bottles that I’ll sometimes use. Whatever it is, it needs to be something you enjoy and something that’s nearby, preferably within arm’s reach so you can drink without even thinking about it.

• Install and use a page-blocking extension to keep you from wandering off out of habit during the day. I’ve used and can recommend both Simple Blocker and Impulse Blocker. You give it a list of sites and turn it on. Once it’s on, when you try to go to the page, it tells you it’s blocked and you can’t go. It’s stupid, but it works. Lot of times I’ll just wander off and click on Reddit or whatever, and when I see the block I go “oh, right” and go back to what I was supposed to do. You can turn this off at literally any time. It’s just a safety net.

Things that help and are comparatively more difficult:

• Exercise. I can not count how many studies out there link exercise and improved ADHD symptoms, while also hitting the comorbid symptoms of depression and anxiety. The bulk of these studies show that even fifteen minutes of just walking results in statistically significant improvements. As it’s warming up outside this gets more difficult, but I want to get back into my routine of early-morning walks in the summer, when it’s absolutely gorgeous out and usually dead calm. Routine exercise also helps with circadian rhythm and the ability to sleep, which leads me to…

• Get your sleep hygiene as close to perfect as you can. My psychiatrist likes to say “sleep is the cornerstone of mental health.” I can’t really disagree with her. Eight or nine hours is the goal. Seven-ish is decent. Less than that is a sign that you need to take this aspect of things more seriously. Sleep hygiene is a term that represents your overall approach to sleep, and improving it means things like turning off electronic screens about 3 hours before you get to bed, not using your laptop in bed (the bed should be for sleep and sex only), and having a set lights-out time. Now, life happens, and we can’t always be perfect at this, but making the conscious effort to do your best will help. My goal is to be in bed by 9, asleep by 9:30, and up at 6. I’m not quite there, but it’s not something to give up on.

• Journaling. I do a lot more writing than what shows up here, and it’s never going to be seen by another human if I have anything to say about it. I consciously sought out a journaling app that offered encryption protected by biometrics, and found three apps for Mac that fit my needs. Journaling is an interesting thing, it forces you to use different parts of your brain than what you use when you’re just speaking, and I think those alternate pathways frequently have good ideas that without an outlet are simply never articulated. Some days the journaling just isn’t working, and I want to do better with scheduled times for it, but it’s definitely something to consider. If you’re reading this and going “I have no idea what I would even write about,” use something that offers guided journals until you start to feel like you’ve got things to say that aren’t addressed. These are the apps:
  • Day One, my go-to for unguided freeform journaling.
  • stoic., my go-to for guided sessions.
  • Ulysses, which I primarily use to write blog posts like this one.
  • For Windows, there is also:
  • Writemonkey, with the Clandestine Files plugin.
  • Standard Notes, which I haven’t used.

• Medication. This is in the comparatively hard category for me because I’ve failed well over a dozen different meds for different disorders. I’m on my 7th try of an ADHD med and I feel like I might actually be getting somewhere for once. It’s really, really easy to get discouraged. There are side effects. You’re angry, or you’re on the toilet all the time, or you get headaches. It can feel incredibly defeating. Keep trying. It can be so worth it in the end.

• Use the pomodoro method for work. 25 minutes of work, five minute break. Repeat twice more. 25 minutes of work, 15 minute break. Repeat the whole sequence throughout the work day, replacing the breaks with lunch where appropriate.

• The GTD methodology. I will openly acknowledge the point in my life where I felt most effective was when I was relying heavily on GTD. It’s honestly a great read with a lot of interesting ideas. I was making heavy use of Trello with it. The different phases of GTD were different boards, and the Next Actions board, for me the most crucial one, was split into the columns of Now, Next, Soon, Later, Someday/Maybe, Waiting, and Done. “Now” can only have 1-2 items in it, “Next” can only have 2-3 items, “Soon” should top out around 5, and the remaining columns have no limits. Every Friday at 2 I would begin an exhaustive processing of every item on every board. This worked really well for a number of months. Then I switched jobs and the methodology didn’t work as well. It may be a huge help, it may be no help at all. It does take constant care and feeding to be effective, and it needs to be one of the most in-your-face things throughout your workday. There are purpose-built tools for this like OmniFocus and Nirvana, but I was honestly most effective with plain old Trello.

Things that haven’t worked:

• A high degree of structure to the day. I’ve tried this a couple different ways and failed consistently. I think it comes down to trying to change too much at once. I had used an app where I could map out my day, from the time I got up to what minute I should be brushing my teeth to when I should be heading back from the gym. It just becomes overwhelming. I think we benefit more than most from some structure, but I think it has to build organically. Perhaps we think of structure when we should be thinking about building habits and routines. I found a pretty good app for that, which I reviewed here, called (Not Boring) Habits. You get a sense of progression without worrying about streaks, and you can get to a place where they really do become second nature.

• Keeping the same alarms, notifications, etc. long-term. I eventually ignore just about anything if I see if often enough. I have to occasionally find new apps that do the same sort of thing. If it’s like an alarm clock, I might have to switch from my watch going off to the alarm clock to my phone itself, changing ringtones, patterns, and so on. If it’s reminders, I might have to switch from the native Reminders app to To Do to Todoist to Things. It keeps things fresh and once you’ve found a large enough variety of tools you can start to just cycle between them over time.

• “Just buckle down.” Yeah it doesn’t work that way, man. I wish it did. A lot of people don’t seem to understand that this is like trying to describe the color red to a blind man. I understand intuitively what you’re saying, but you’ve given me a destination without a map or directions. The fancy term for this is executive dysfunction. Similarly, “Just get a planner.” I have accumulated a wide variety of them over the years, many of which are pristine past the first 8 or 10 pages. For me, pen and paper feels very inefficient, and I haven’t observed that it buys me anything in terms of productivity, it’s never felt like a natural habit.

• L-Tyrosine. Anecdotally I noticed no difference taking it versus not. Fish oil and ginkgo biloba are in the same boat, and recent meta-analyses have cast doubt on their efficacy compared to placebo.

• Cutting back, or eliminating alcohol altogether. There are plenty of other reasons to do this, but it doesn’t seem to really help with ADHD symptoms.

I may come back to update this periodically with new findings.