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Strategies To Lean On During The Stimulant Shortage

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If you have not been hit by the shortages of stimulant medication, consider yourself lucky. Maybe even blessed.

On various forums and FB groups, I’m seeing posts from people who haven’t had their medication in weeks, or months. People calling around to different pharmacies, and in doing so, feeling like (and sometimes being treated like) a drug seeker. 

And no one knows when this will end.

While some ADHDers have switched medications to one that is, at least currently, not in short supply, that doesn’t work for everyone. Some medications just aren’t the right medication for everyone; add to that the insurance barrier, and you have people who are truly not living their best lives right now-and even worse than that.

Here are some strategies that, while totally not replacing your medication, can mitigate some of the loss in focus, regulation, and organization that you might be feeling.

1 – Recognize that your life is being impacted. Because of society’s often dismissive attitude towards ADHD, it’s easy to fall into the “I shouldn’t need this medication to function anyway.” ADHD is a result of neurological and brain chemistry differences that cause issues with task management, time management, attention, and emotional regulation. It is not a choice. These challenges are mitigated by medication, just like vision issues are mitigated by glasses.

2 – Lean hard on lists, calendars, Post It notes, reminders. Even if these have not worked in the past, at this point they are what you have. If you need to write a giant list of your morning routine to post on your bathroom mirror, do it. If you need Alexa to ping you every 10 minutes to make sure you’re on task, do it. Using a calendar, task management system, and bullet journal? That’s fine. What might seem like overkill when you’re medicated is actually a failsafe system during this emergency.

3 – Automate as much as you can. This is actually a great strategy even when you can get your medication. Auto refill on meds (yours, family, pets), auto pay on bills, anything that can become something that you don’t have to remember is a good thing.

4 – Make sure you are getting the right food and sleep. Having protein at breakfast is crucial! It’s brain food! Your ADHD brain might crave sugar, but that will cause a crash that you will have a hard time bouncing back from without your meds. Also, getting the right amount of sleep for you is super important. You might have a difficult time falling asleep; think about what might help you to have more success (sleep routine, putting screens away earlier, reading before bed…just a few suggestions!)

5 – Exercise! Studies have shown that exercise is an important part of an ADHD treatment plan, whether medication is involved or not. Going for a walk, jumping jacks, yoga, a YouTube exercise video, dancing to music in your kitchen-anything that gets you moving is going to provide dopamine to your system. I cannot stress enough how important this is.

6 – Try body doubling. Body doubling is working on something while someone else is also working. You do not need to interact, or be working on the same project or assignment. For example, I can be paying my bills, while you fold the laundry. This strategy is very effective in eliminating procrastination and increasing on-task behavior. If you don’t have someone you can body double with, you can use a body doubling website (Focusmate.com is a good one), and be set up with someone with whom to work in tandem.

7 – Lean on your support system shamelessly. If you have an understanding spouse, parent, friend, ask them if they can help you out during this crisis. They might be able to insert some accountability into your task plan (a text asking if you’ve done something), to help keep you on track (and If you don’t have an understanding person in your life, well, that’s a topic for another blog post).

8 – Realize that you will not be able to attend to everything at the same level as you did while you were medicated. Decide where your focus should be. If it’s work, then let the housecleaning slide. If it’s taking care of your kids, then maybe order in for a while instead of meal prepping. In other words, expend your energy wisely.

9 – Be extra cautious while driving. Research shows that adults with ADHD are more likely to have car accidents than adults without ADHD. While stimulant medication can mitigate some of the danger, when you can’t get your meds, you are at risk. Take a breath before you start the car to get centered. Put your phone in the trunk. Shut off the radio. If you have a passenger and their conversation is distracting you, ask them to stop talking-I think they’ll be less offended if you tell them it could save their lives.

10 – Keep up with your appointments with mental health professionals, and let them know if you are struggling. You might be able to try a different medication. Your therapist might be able to give you some ideas for dealing with the anxiety that this can cause. 

It can be very discouraging and frustrating to be unable to get your medication, something that enables you to live your best life. You might feel sad, angry, scared-these are all valid feelings when you don’t feel like you are in control. Don’t let anyone tell you that “it’s no big deal.” It IS a big deal-but by adopting some of the strategies above, you may be able to move through this crisis with a little more ease.

How Accountability Partners Help, And Why It’s Not Nagging

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According to research studies, publicly committing to your goals translates into a 65% chance of completing them. But, if you want real firepower, having an accountability partner increases that to 95%.

A 95% chance of meeting your goals? That’s almost a sure thing! What is this magical accountability partner of whom you speak??

An accountability partner is a specific person with whom you share your tasks and goals, and then to whom you report back your progress. Some people have accountability buddies that are attempting to work towards the same benchmarks, or on the same events; for example, if two people are training for a marathon, they can have a common plan, and keep each other motivated. 

It is important to note, however, that accountability partners do not have to be involved in the same activity. I often act as an accountability partner to my clients, and if they are training for a marathon….well, that’s not happening on my side of the fence!

Why does this work? And what makes this different than having someone just nag you to do something until you do it?

People tend to perform differently when they are being observed (think about when your boss is walking around, or when company is coming over and you’re frantically cleaning). So if there is someone that is going to be cognizant of whether or not you complete what you’ve committed to, there is a greater chance that you will stick with it. And if it’s more personal – for example, telling one friend that will follow up with you, versus the ubiquitous Facebook announcement – the odds that you will really work towards meeting that challenge grow astronomically.

But how does this differ from having your husband, wife, mom, etc, call you up and say “Did you get your oil changed?” And when you say no, they ask “Well, why not? You know that’s going to ruin your car! And then…”

Because an accountability partner has no skin in the game. They will simply ask you “Did you get your oil changed?” And when you say no, they say…nothing. Or they say “do you have a plan for that?”

So accountability partners live in a judgment-free zone. There’s no nagging. If you accomplished your goal, high five! If you didn’t, they don’t want to know why not. It’s your problem to solve.

What can work really well is to have a reciprocal accountability buddy arrangement. So, you ask me about my oil change, and I’ll ask you if you’ve gotten the dog her shots. Again, no nagging, but it’s nice to have a level playing field. And both partners benefit!

I’ve tried out accountability partners this family members on a reciprocal basis – meaning I have someone I’m accountable to as well. Let me tell you, when I know that on Friday afternoon I’m going to have to report to my buddy about my progress, I am WAY more likely to actually have made some! 

So, give accountability buddies a try! See how it feels..and watch that productivity skyrocket!

Why A Coach Might Recommend Therapy

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Recently, I was invited to present to a group of therapists on ADHD coaching. The goal of the presentation was to introduce coaching to the therapists, describe the benefits, including the evidence to support the success of coaching as an intervention, and to delineate the differences, and crossover, between ADHD coaching and therapy.

I receive inquiries from potential clients that are hoping that coaching will help them to address their challenges related to ADHD; that is my hope as well. But sometimes, these potential clients are not “available for coaching.” And therapy, either while in coaching or prior to starting, would l enable them to move forward.

Having ADHD can cause one to doubt one’s abilities, sanity, and value. It can ramp up anxiety; it can, when challenges become too great, cause the ADHDer to sink into depression. 

While it would seem that addressing ADHD challenges would cause ones mood to lift, anxiety to lessen, and self esteem to rise, the past is still there. The feelings of being “less than” might dissipate; but having had those feelings before coaching can still get in the way, because they are ready to jump up when something doesn’t work.

For example, let’s say one of the strategies that a client and I discuss as a possibility is having a morning routine that includes taking time to eat breakfast, while sitting at a table with actual silverware and plates (by the way, a great way to start the day!). So, my client tries this out, finds they look forward to it, and so are more apt to get up on time. A win!

Until the day they oversleep.

And then, there is no time for this luxurious breakfast. There’s barely time to shower. And the entire time, the messages of the past pop up, sometimes in the voices of parents or teachers, ready to destroy the client’s self esteem and good feelings.

Now if this happens once in a while, it can be addressed in a coaching session. But if the client is struggling, these events of the past, and the subsequent emotions they evoke, can really get in the way.

Potential clients sometimes want the shortcut (really, who doesn’t?) They want the answer to how to deal, without addressing what has been before. However, shortcuts that ignore how a client shows up for support don’t work. And any responsible coach will tell you that.

Therapy addresses your past. Therapists help clients to explore what happened, how it impacted one’s emotions and self-talk, and how to deal with those pesky messages in the future. And when clients have dealt with their past, coaches are there-ready to walk side by side with clients, into the future.

What’s The Deal With Gratitude Journals?

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I’m not sure how many of you are from the New York City area, or have been there, or have just seen it on television. However, I think it’s fair to say that most people, when they think of New Yorkers, think of tough, unfiltered, often rude people, who do not tolerate B.S. ever.

Not only am I a born and raised New Yorker-I’m from Brooklyn. Telling this fact to my former students on Day One of school prompted good behavior for at least a few days.

So when Oprah started talking about gratitude journals, and stopping to notice the birds and flowers, I thought that the idea was ridiculous. “Who has time for that?” I thought. “Sure, I’m grateful for a lot of things and people in my life, but can’t I just be grateful and not make a big deal out of it? I know that I’m grateful, no one needs to tell me how to do it.” 

And there’s no way I needed another item on that to-do list, right?? It’s overflowing as it is.

Of course, as with most things, Oprah actually had it right. Especially for someone like me.

You see, having that tough Brooklyn persona requires keeping your feelings hidden-with the possible exception of anger. The whole premise of being a New Yorker is being unflappable. Add ADHD into the mix, and there can be the guilt and shame associated with missing deadlines, etc.-being tucked away where no one can see.

However, being that stoic, unaffected human doesn’t just keep you from getting carried away when something bad happens. It also prevents you from getting pumped up about the good, particularly the little things that can go unnoticed. In fact, not only can you miss acknowledging them-it might, in fact, be uncool to do so. Who stops their day to note their gratitude for the technology that lets you pay your bills online, and therefore on time?

Well…now I do.

I don’t know what possessed me to start my gratitude journal-I think I was given a really nice notebook, and wanted to use it. I try to take note of the small things-my dog’s soft ears, talking to my kids, having a productive day.

Having this become a habit has trained me to notice things I’m grateful for during the day, so I have something to write about. I consistently notice the good things in my life, which in turn lifts my mood.

When one is dealing with ADHD, finding that little kernel of happiness in a day can sometimes be the key to persevering. To saying, “Okay, I paid that bill late. But I’m not a loser. I’m grateful that I only paid it two days late, and that I’m smart enough to find a strategy to help with this.”

Plus anything that helps one focus on something is always a good exercise for ADHDers.

Neurodiversity, From The Inside

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In honor of Back To School, today’s blog post was actually written by my son. It was his Diversity Statement for his law school applications, written seven years ago (he has since attended law school and become an attorney). 

While I know it’s impossible for me to be objective, this essay is one of the most poignant pieces of writing I’ve read about ADHD. On the one hand, it hurts my heart to think about my son, a little boy, struggling with feeling so different, and being made to feel just…wrong. But on the other hand, I am so proud of him, of the person he is (and was all along), of how he has battled the struggles of ADHD, and continues to persevere. He is one of my heroes, and I feel blessed and lucky to be his mom.

Scattered among my old papers and school supplies are dozens of painstakingly crafted childhood dalliances–trail maps of fictional ski resorts drawn in my free time, hundreds of loose-leaf pages of notes and classwork from my academic career, the words therein corralled by extensive marginalia and doodles– reminders of the all the time I spent in my own little world.

Since my preschool days of apathetically watching my classmates entertain themselves by scouring the floor together collecting staples, I knew that I had a talent for getting enthralled in my own thoughts at the expense of the outside world.  When my kindergarten teacher excoriated me for being “rude little boy” and spacing out during math, or when my ninth grade history teacher scolded me daily for asking questions that had already been answered, I wondered why my peers had no trouble focusing in class, relating to others, or being “normal.”

Finally, I discovered the name of my affliction; ADHD.  But I was surprised to learn that this was more than just a daunting obstacle.  Certainly I would need to offset my focus problems with color-coded school binders, and by ensuring that my homework was complete before watching TV–and I have continued to employ similar strategies to this day.   My doodling habit, far from distracting my easily-misled mind, has become a means of stimulating creative thinking and focusing my scattershot thoughts on the task at hand.  Yet I have also found that ADHD causes me to selectively and intensely get absorbed in the things that actually interest me.

This “hyperfocus,” a component of ADHD, gives me the opportunity to turn things over in my mind in a unique way, and  has caused me to develop a unique perspective. So whether I was telling my friends about the Loch Ness monster in third grade, or finding nuances in situations for use in my sketch comedy class, I can draw conclusions that others might not, and use these seemingly quirky observations as a bridge to others, instead of the wall it once was. 

Making Habits Stick

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Many of us, whether neurodiverse or neurotypical, have difficulty making habits stick. We can have great reasons for these habits, they can improve our lives in ways big and small, but still – we just can’t get it done.

For example, I would really like to get in the habit of cleaning up my kitchen every evening. Sure, we do the basics – dishes, table cleared, food put away – but what I’m after is wiping down the counters, stove, and table, and sweeping the floor, every single day. I have great reasons for this – it’ll make weekly cleaning so much easier, the kitchen will always be clean and ready for food preparation, it’ll be nice to come in for my morning coffee and see a neat, clean room.

But somehow, nighttime comes, and although cleaning up the kitchen would take me about 5 minutes, it is impossible for me to get myself to stand up and do it. 

What am I doing wrong??

While reading B.J. Fogg’s book, “Tiny Habits,” I discovered my mistake. It’s all in the timing.

I think many of us try to complete whatever behavior we are trying to make habitual before doing something we would actually like to do. The logic is that if I can’t do what I want to do until I do what I should do, I’ll be more apt to just get the habitual behavior done. So, in my example, I try to clean up before sitting down to watch Jeopardy! In the evening.

This, my friends, does not work. 

All this does is bring out the 10 year old in all of us, who says “You’re not the boss of me! I’m going to go watch Jeopardy! And I’ll clean up later on!”

Except…we don’t. We get comfy on the couch, and before you know it, it’s bedtime, and no cleaning is coming between me and my pillows.

According to Fogg, founder of the Behavior Design Lab at Stanford University, the inclination to hook two behaviors together is correct. But we need to pair the new habit with something we already do – and take on the new behavior after one we already engage in.

So, taking my example further, I thought about my evenings, and realized that I make myself a cup of tea almost every night. I get up, go into the kitchen, prep my teacup, and put it into the microwave for a little over a minute.

Following Fogg’s instructions, I found a step in my tea-making that I could place something after – in my case, turning on the microwave. Once I heard the microwave start, that was my signal to grab my sponge and start to clean.

And you know what? This worked! And I didn’t feel resentful, or annoyed. I felt accomplished.

Is there something you know you’d like to make a habit, but have been struggling to do so? Try using the “after ____________, I will do _____________” method from BJ Fogg.

Who knows? Maybe after making a habit stick, you will start a new habit based on that one. And on, and on, and on….

Bundle Up: How to Look Forward to Your Chores

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We all know that feeling of dread – it’s time to clean the bathroom. Clean out the garage. Go to the gym. Wash the dog.

For neurotypicals, after a battle between that dread, and the feeling that you should be doing said dreadful task, the task wins, and off they go wielding a toilet brush – maybe grudgingly, but they go. 

However, ADHDers have a different approach. When faced with a low dopamine task, ADHDers will avoid it. The consequences of ignoring the task – a messy house, a smelly dog – are in the future, and therefore, aren’t important. The ADHDer knows that cleaning the bathroom would be a good thing to do, but without the urgency of “someone is coming over today!” it just doesn’t happen. Add in some shame at having avoided the task, and you have the recipe for classic ADHD living. 

But there is a way to make those tasks more palatable. Dr. Katy Milkman, professor at the Wharton School of Business and renowned researcher, discusses what she has termed “temptation bundling” in her book “How To Change: The Science of Getting From Where You Are to Where You Want To Be” (which, BTW, is a really great book, super readable and terrific ideas).

Temptation bundling is the concept of putting together a source of instant gratification with a less desirable but “should” activity – so, in sticking to our example, cleaning the bathroom while listening to a podcast that you love. Per Milkman’s research study, when subjects had an indulgence “bundled” with something considered a chore, their participation in the “should” activity increased.

There is a caveat here. In the study, participants only had access to the fun activity while participating in the required activity. So that means that whatever you choose to bundle with scrubbing that toilet, it can only take place while the brush is in hand.

I use temptation bundling often. I have a particular podcast that I only listen to when I’m cleaning. I put my tea in to steep while I’m cleaning up the kitchen after dinner. I only listen to my workout music playlist, well, when I’m working out.

And I will tell you – this works! 

Is it hard to resist the urge to do the “fun thing” at other times? Yes, it can be. One way to avoid that as an issue is to schedule your chore right after the indulgence becomes available – so, as one of my clients is doing, cleaning on the day after two of her favorite podcasts come out. But if you don’t have that flexibility, you might want to consider something that you can put aside – maybe an audiobook, or TV show that you like, but can wait to watch.

So, instead of putting that toilet brush away, see if you can bundle it with something fun. Science says it works; hopefully you will too.

Zeroing In On Email

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I just spent the last two weeks traveling across the country, and back, by car. With my husband and dog in tow, we saw the world’s largest rocking chair, the alleged birthplace of James T. Kirk, and most importantly, our son and his fiancee. It was a busy, fun vacation.

When you have your own business, or have people counting on you, it’s pretty tough to put up one of those “Annette Lang will be on vacation until….” messages without feeling guilty, panicky, or both. On the other hand, I needed a break from the everyday. 

So I decided that this would be a great time to try out the idea of a Zero Based Inbox. Here’s how I did it.

1 – First of all, I looked through my emails from the past two weeks, deleting anything I didn’t need. I then archived everything prior to that.

What?? Get rid of all of those emails?? Nope! Archiving just gets them out of your inbox, into some storage room for emails you might need one day but probably don’t. It’s like keeping those linens that you never use-just in case a family of eight takes up residence with you, you’re ready! But until then, those sheets and towels are out of sight.

2 – I then made three labels (I use Gmail, I believe Outlook has similar capabilities): Action, Info, and Review. You could choose whatever would work for you. Whenever I read my emails, each one went into one of those labeled spaces.

My inbox? Empty. 

The whole idea is to stop using your inbox as a storage area. Seeing that inbox “unread” number can be so intimidating, and can make even the strongest among us click out of that email tab, and call it a day.

3 – I checked my email a bunch of times during the day. By checking, I mean looking at the email, and either deleting/archiving it or labeling it with one of my three labels. I found a really nice app called Triage that enabled me to quickly go through my emails, and either archive or leave in the inbox. I’d then have a lot less to deal with to zero out my Inbox.

I saw myself starting to overthink the best label for each email, and so I gave myself no more than 30 seconds to classify an email. If, when I’m reviewing them, I find I put it into the wrong sort, I can always move it.

4 – I then designated a couple of times a day to go through my three labeled areas. Action was looked at, but because I was on vacation, I didn’t really act on any of the emails in there, other than to respond to a couple, letting the sender know I’d get back to them when I got back.

Review was reserved for emails I needed to really focus on to read. They might have links to articles I’d find useful, or I might not be sure how to proceed. So I’ll review, or read them again.

And finally, Info is for just that. It includes zoom links for meetings (which I put on my calendar and then delete), and other information.

And that’s it!

Guess what? Every time I see that empty inbox, I get a little zing of dopamine. Which is a whole lot better than the thud of “Ugh, I have so many emails.” 

Not to mention that anticipating getting that little sparkly feeling causes me to check my email regularly, instead of avoiding it. And setting up specific times on my calendar to get into greater detail with my email has not only helped me to do so, but has also enabled me to eliminate getting bogged down in my emails when I need to be doing something else.

Now that I’m back from my trip, I’m getting back into my normal routine. But my Zero Based Inbox is one souvenir from my trip that I am going to keep.

Perfectly Imperfect

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“And now that you don’t have to be perfect, you can be good.”

― John Steinbeck, East of Eden

When I first saw this quote from one of my favorite authors, it really hit me between the eyes. I’m sure there are many interpretations of it, but to me, it meant that now that so much energy and worry and thought didn’t have to go into perfection, one could actually just be good enough. And that’s okay.

Many ADHDers struggle with perfectionism-something that those who don’t have a personal knowledge of ADHD probably find counterintuitive. How could anyone who can’t/won’t/doesn’t pay attention/do things on time/stay organized actually care about being perfect??

But in reality, all of those years of mistakes, and late assignments, and impulsive actions can add up to a lot of fear and anxiety that is expressed as perfectionism.

This tendency can lead to procrastination, feelings of failure that then cycle into more perfectionism, and just a general lack of motivation and positivity. Because if your standard is that you must be perfect, who wouldn’t dread attempting a task??

In other words, perfectionism is bad for your health, mental and otherwise.

So, how to break that pattern? Here are some ideas:

1 – Develop Mantras – “Done is better than perfect” or “Good enough is good enough” are two ideas. Practice repeating these to yourself; also pop them on a Post-It on your laptop or desk, and other places you can see it.

2 – Use a timer – For tasks that should be simple to complete (writing an email, wrapping a gift) determine how much time it should take (perhaps time it once before using this strategy), and set a timer. When the timer goes off, it’s time to stop.

3 – Keep a “done” list – keeping a list of what you were able to accomplish makes you feel good. Bonus points for things that were complete, but they weren’t 100% perfect.

4 – Name your Perfectionism – find a shorthand way to name your perfectionism, so that you can easily become aware of being held hostage by it. Awareness is the first step to change! It’s also fun to say “Shut up, Penelope Perfect” when you’re hearing that voice in your brain.

5 – Practice doing things imperfectly – no, I’m not saying ruin all of your clothes by washing your wool sweaters in hot water. But little things-leaving autocorrected texts alone, sending an email without re-reading it more than once, quickly-and seeing that the world doesn’t end when you do that, can be a good way to get accustomed to imperfections.

It’s not easy to break the perfectionism habit. Your brain has been telling you that everything must be just so for a long time. It takes time and practice, so be gentle and patient with yourself. Getting to the point where you can giggle a little at your perfectionism seems to be a place to aim for.

Because, as Steinbeck said, now that you don’t have to be perfect, you can be good.