ADHD and the Eight Fold Path: The Practical Truths part two: Right Coaching and Support.

At long last I've come to the final of these posts regarding the Eight Fold path to the treatment of ADHD. The final truth to discuss is that of Right Coaching and Support. I use these terms sort of loosely because they can mean different things to different people. The key idea here is that people with ADHD need three things in order to maximize the effectiveness of treatment:

1. Support: Especially at first, but even as the years go by, people who struggle with ADHD need support. Support can be as simple as someone who can remind them of things from time to time, or at least be understanding when things are forgotten. Support is also non-judgmental. Even though you may have forgotten to mail out the bills three days in a row, the person providing support must be able to look past the error and ask "so what's your plan going forward?". Spouses and Parents are not always able to manage non-judgmental support at all times, which is why a professional Coach or therapist can be so valuable.

2. Accountability: People with ADHD need accountability. The phenomenon of getting things done at the last minute is the embodiment of the power accountability can have. To a certain extent we are all accountable to someone. The person with ADHD needs to have the feeling that someone is waiting for them to complete a task. This someone needs to be real, specific and have a connection with them. The credit card company isn't really specific enough. In addition, the center of accountability once again must be non-judgmental. No one wants to be accountable to someone that yells and calls you names if you're late or make a mistake. This leads to avoidance and the need to make up stories, also known as lying: Yes professor, I turned that paper in ages ago! What do you mean you can't find it? Non Judgmental accountability provides the impetus to complete a task, with the feeling of knowing that you are being supported and encouraged to meet your obligation.

3. Finally people with ADHD need understanding. People want to do well. No one likes to feel they are a screw up or hopeless. Having someone in your life who understands you, and the effect ADHD has on you, is invaluable. Being able to say to a Coach, a spouse, a parent, or a friend that you had an "ADHD Moment"(shameless Blog Title plug :) ) and be able to laugh with them about it can mean everything. Having them offer a kind word of encouragement can mean the difference between success and failure for many people.

In closing, finding the right person or persons to offer you support, accountability, and understanding may be one of the key things you can do to treat your ADHD. It is a life long process. Be patient and celebrate small successes.

The Eight Fold path And ADHD: The Practical Truths Part One

The Practical truths for ADHD treatment are those things that deal with day to day life. Everything leading up until now has been about building a foundation for success, and an end to frustration and suffering. Now it is time to take the foundation and begin to build a new life upon it!

The Seventh Noble truth is that of Right Organization and Prioritization. People who have ADHD are often very capable, hardworking, and able to laser focus on a task for hours. The problem is that many times, the task itself is really not a priority or is something that will actually delay urgent tasks from being completed. This where prioritization becomes so key; you have to be able to look at everything that needs to be done, and the order that it needs to be done, in order to ensure you are working effectively. For someone who does not have ADHD or Executive Function challenges, this would seem obvious. But, all too often, the person with these challenges will jump into a project with very little idea of what they need, or how long it will take. Additionally, they may not recognize that while it's fine to tackle painting the house, or cleaning out the garage they actually have to pay the mortgage so they'll continue to own the home!

Hand in hand with learning to prioritize is taking the time to organize. This is the great "stopper" in many people's lives, because the task can feel overwhelming. Taking the time to methodically organize your desk, your bills, your tools, or any number of other things can seem like a boring, dreadful experience. However, knowing where things are can become the one key thing that allows you to be successful in so many ways. Here's an example: hang a basket by the door of the house you use the most. In this basket put your car keys, sunglasses, parking pass, outgoing mail, and anything else you will need to get yourself out the door in the morning. Put an extra set of everything in the basket if necessary. The time, aggravation, and negative self talk you will avoid by doing this can turn your entire day around.

It is hard for people with ADHD to learn the skills of Prioritization and Organization, but they can make your life better, less stressful, and allow you to focus on the tasks ahead of you. Not everyone can do it alone! That's why our final Noble truth will be discussing Right Support.

ADHD and the Eight Fold Path: The Mental Truths Part Three: Right Medication

There is so much discussion surrounding medication for people with ADHD. There are those who think medication should be the first line of treatment. There are other who think it's wrong to utilize medication, especially in children and teens, and advocate for a drug free approach. There is the usual collection of fringe types who insist that meds are not really effective and it's the pharmaceutical companies who are pushing this method of treatment. Finally, there is still a vestige of moral guilt on our parts that seems to whisper: "you're taking the easy way out by swallowing a pill. You should have the moral fiber to overcome your problems without medicating yourself."

As with any discussion that is charged with emotion and tinged with feelings of guilt, the decision whether or not to take medications for ADHD is not an easy one. But I urge you to hear me out on this; don't let emotion drive your decisions. Don't be cowed by the often times ill informed opinions of family and friends. Take a deep breath and consider the situation through calm, rational eyes. Remove the emotion from the process. Here is what we know:

1. Treating symptoms of ADHD with stimulant medications has been going on for quite a long time. It was first tried in 1937, and had such immediate and excellent results that it has continued to be used (albeit with better more advanced formulations) ever since. Think about that for a moment. We have been using stimulants to treat symptoms of ADHD for almost as long as we've been using antibiotics.

2. Clinical research and patient data show that approximately 90% of those who use medication to treat ADHD symptoms experience improvement in performance.

3. Use of medication in conjunction with other modes of treatment (Therapy, Diet and lifestyle changes, Coaching, etc) enhances the effectiveness of the other interventions.

Right Medication for ADHD is the decision made after careful consultation with qualified health care professionals. A person may decide to forgo medication all together, or they may decide to try it and see what works. Regardless of the decision, Medications must be evaluated as a key element of any treatment plan. You wouldn't deny a diabetic insulin, or a child with strep throat antibiotics because you "don't believe in giving kids drugs". Don't deny your child or yourself the opportunity for relief from the symptoms of ADHD out of ignorance. Educate yourself on the options and make an informed decision.

The Eight Fold Path And ADHD: The Mental Truths Part Two

The next of the Mental truths to consider is Right Therapy. Many people benefit from seeing a therapist. As we go through life, we can pick up baggage and negative habits that are hard to shake. We can be too hard on ourselves, or blame ourselves for things we couldn't prevent. We can hold on to times when we were hurt by others. We can harbor anger and resentment that festers inside of us. None of this is healthy, and because we are so close to the situation we cannot objectively deal with it. The Therapist becomes your ally in wrestling with these things. Because they are non judgmental (or should be anyway), you can talk through things and be prodded toward finding a way to resolve old issues, and create new more positive ways of thinking.

For the person who has ADHD therapy can be so liberating! A good therapist can help you work through all those negative feelings you may have had abut yourself, about your abilities, and about all those mistakes you made. Many therapists can help you retrain they way you react or think about situations through CBT (Cognitive Behavioral Therapy) techniques. They can also help you to resolve feelings of doubt about your condition. It's not an excuse, and no, it's not your fault.

I see therapy as a key piece of multi-modal treatment. People who have lived with undiagnosed ADHD have lived with frustration, disappointment, and a variety of other negative emotions for much of their lives. This inevitably leads to damage to their self esteem. It is no coincidence that Depression is a very common condition (also called a co-morbid condition) for individuals with ADHD. Another very common condition co-existing with ADHD is anxiety. While medications can help alleviate the symptoms, therapy is crucial to retraining our thoughts and achieving the acceptance and forgiveness we all must find to move forward in our lives.

The Final mental truth is that of Right medication. This particular topic is rife with stigma and controversy. I'm looking forward to throwing my two cents in on this topic!

ADHD and the Eight Fold Path: The Mental Truths Part One

Continuing on with the series of posts that is taking far longer than I expected, we now turn to the second part of the Eight Fold Path, or the Mental Truths. This could also be called the psychological truths, but it's easier to type mental, so we're going with that. These Truths are as follows:

1. Right Acceptance and Forgiveness

2. Right Therapy

3. Right Medication

When someone is diagnosed with ADHD, there is a weird process that happens. At first there may be a sense of elation. You finally have a reason for all the screw ups in your life! You have a disorder! You aren't such a loser after all! But doubts creep in; am I really justified in feeling better about myself? Am I just using this as an excuse? Do I really deserve to be let off the hook for all the mistakes and sins of omission I have made? Do I really have a disorder?

I'm not an expert, and I'm definitely not going to say that this is a universal experience. But I think it's important to recognize that until recently, ADHD was not a valid reason for an adult to have difficulty with being organized, on time, and generally capable in the executive function arena. In fact the likelihood is that even people in your life who say they recognize ADHD is a legitimate disorder, and can impair performance are still thinking on some level "yes, but you still should be able to mail those letters I gave you!" Indeed, a person diagnosed with ADHD may be having an internal dialogue with themselves that is similar to this. But in order to effectively treat ADHD, it is important to recognize that a person must be willing to do two big things:

1. Accept that they have Neurobiological disorder that is just beginning to be understood. Accept the fact that no amount of will power or sense of purpose could have prevented or changed times when they forgot appointments, or were totally disorganized. Accept that many of their tendencies are not a moral failing. Accept that they must now take responsibility for treating their disorder.

2. The second big thing is they must be willing to forgive. This is a big one, no question about it. Forgiveness may be given to people who didn't understand, such as parents or teachers. But the bigger issue is that a person who has ADHD must be willing to forgive themselves. Forgive themselves for all the things they felt they should have been better at. Forgive themselves for all the half done projects, the impulsive purchases, the missed opportunities. The old expression "To err is human, to forgive is divine" contains a great deal of truth.

The path to a better life cannot begin without Acceptance and Forgiveness. In my opinion, these two things are vital to the healing process, and they are not easy. That is why, in our next post, we'll look at why Therapy can be so vital.

ADHD and the EightFold Path: The Bodily Truths part three

The final Bodily truth is Right Nutrition. You need to start thinking about the things you put into your body. I'm not saying you need a special diet. What I do want to stress is that bad eating habits and poor food choices doesn't help you in the least. People with ADHD do have some special challenges in this area: we tend to be running late, so meals might be skipped, or fast food becomes a staple of the diet. We have a hard time planning, so grocery shopping and meal preparation can be spotty at best. This makes Right Nutrition even more imperative. By treating your body well, you are treating your brain well, and giving it the raw materials it needs to function effectively.

Here are the points I consider key to eating well:

1. Eat breakfast every morning. There are a number of studies that show kids who eat breakfast do better in school than those who don't. If you have ADHD this alone should motivate you to make sure you eat first thing in the morning.

2. Avoid Fast Food. It's not good for you, there's questionable content, and there are far better choices out there.

3. Avoid junk Food. Ditto on the above reasons. Human Beings do not need chips to survive.

4. Skip the Soda. Drink water instead. It's much better for you. If you miss the carbonation, drink seltzer water. If you need the caffeine, black coffee or tea will do just as well, and they have anti-oxidants to boot!

5. Eat fresh food as much as possible. Make sure you are eating fruits and vegetables every day. Eat Protein and Carbohydrates in balance with one another, and keep fat to a minimum. There's no mysteries here!

6. Don't drink alcohol if you're under age. Your brain is still developing, and booze is not something you need. If you're an adult, avoid alcohol in excess. If you find your days challenging as it is, throw a hangover into the mix with ADHD and see how productive you feel.

While this isn't nutritional advice per se, I'll just add it to the mix: smoking or using tobacco products, taking illegal drugs or misusing prescription medication is harmful to your body and your mind. People with ADHD have a much higher prevalence of substance abuse than the general population. The need for stimulation causes many people with ADHD to engage in risky behavior, including drug and alcohol abuse. You should seek help if you or someone you care about is abusing drugs and alcohol. Like ADHD, this is a treatable disorder.

The Bodily truths are the foundation for the successful treatment of ADHD. By getting your "house in order" so to speak, you will be ready and able to manage your ADHD far more effectively. Our next Posts will examine the Mental Truths: Right Acceptance/Forgiveness, Right Therapy, and Right Medication.

More information on Spark

I keep referring to Spark by John Ratey in these posts. It's a great book, well worth reading for everyone, not just people with ADHD.

Here is a link to a place where you can buy the book on Amazon.com. I'm not getting a dime for this either: http://www.amazon.com/Spark-Revolutionary-Science-Exercise-Brain/dp/0316113506/ref=sr_1_1?ie=UTF8&qid=1288215164&sr=8-1

Check it out!