Top 5 Techniques for Adults Thriving with ADHD
“ADHD is both a liability and a super power!”
This is one of my favorite quotes by Dr. Ed Hallowell, MD (a world-renowned expert on ADHD who also has this condition, in addition to dyslexia). Dr. Hallowell understands the struggles of living with ADHD and the crushing blow it can have on one’s view of themselves, and he also is on a mission to help the world see the strengths of this “way of being”. Another favorite saying by Dr. Hallowell is:
I don’t treat disorders. I unwrap gifts.
Yet, many adults I’ve come across with ADHD do not view this condition as a gift (in spite of their talent, accomplishments, intelligence or people skills) because they haven’t yet been able to get a handle on it and their struggles cause feelings of overwhelm and hopelessness. More often, I hear them say:
“ADHD is ruining my life!” followed by “I’m afraid of losing my job or my partner/spouse!” or “I’ll never achieve my potential/live a well-balanced life” because of a variety of ADHD symptoms, such as… I can’t consistently… stay on top of my work, remember the long “to do” list my spouse has for me, stay organized, finish projects at home, focus on conversations with my partner, keep track of important things (like my car keys!), maintain self-care, etc.)
The EXCELLENT NEWS, if you are an adult who has ADHD or believe you might have ADHD, is that the strategies below work WONDERS! They are based on 25+ years of research and learning from thousands of clients of Dr. Ratey and Dr. Hallowell.
I also know what it’s like to struggle with adult ADHD and to worry that my only option was to take medication. After reviewing the classic and most cutting edge ADHD resources and APPLYING several of the strategies below, my ability to take my life back from the challenges of ADHD has grown immensely.
Check out my other blog, “How Can You Live Like That?! Couples with ADHD” as well since I draw from authors’ Melissa Orlov, Hallowell and Ratey’s research about the challenges and successes of these couples and even include how ADHD can affect sex.
This blog is for YOU if any of these questions resonate:
Do you have ADHD and are struggling with “adulting”?
Wonder if you might have ADHD?
Or inconsistently fulfill life’s responsibilities, underperform at work, &/or have impulsive behavior and are not sure why?
Disclaimer– Most of the information in this blog is a summary from the books and interviews of Dr. Hallowell and Dr. Ratey, in addition to my personal and professional experiences. Please see my resource list at the end to learn directly from these experts.
The symptoms of ADHD are a combination of BOTH gifts and challenges.
Step 1- Read this brief list of some of the traits of adult ADHD to see if you might meet the criteria:
- Unexplained underachievement (in spite of IQ, talent, and background – quality of education and training) is a hallmark of ADHD
- High degree of creativity, imagination, inventive, risk taker (such as journalist, Lisa Ling)
- A wandering mind (and the ability to superfocus)
- Trouble organizing and planning and the capability of a highly directed entrepreneur
- High energy
- Trouble with time management, and a tendency to procrastinate (even with writing this blog!) and can get a week’s worth of work done in 2 hours!
- Innovative and ambitious (ex. entrepreneur David Neeleman of JetBlue)
- Restlessness or “woolgathering” (my parents called me “the rummager”)
- Unique sense of humor (Ex. Dav Pilkey, author of Captain Underpants and Dog Man)
- Impulsiveness and impatience
- Intuition and empathy
- Distorted negative self-image
- Love a challenge and have an itch to change the conditions of life
*Please note that the list above is NOT a formal assessment tool. It is a list of tell tale signs that Ratey and Hallowell derived from anecdotal experiences and research of 25+ years.
In order to receive a formal diagnosis, you will need to meet with a professional who understands or ideally specializes in adult ADHD and can administer an evidenced-based tool (such as William Dodson’s adult ADHD assessment). You can also Google “DSM V diagnosis of ADHD” for a more clinical list of symptoms.
Hallowell (& Ratey) have a strength-based and even radical view of ADHD~
ADHD is not a disorder, but a trait and if managed well, it can be an asset!
These authors have also expanded the definition to include VAST = variable attention stimulus trait, which “includes all the people who don’t meet the diagnostic criteria for ADHD, and yet have so many of the key elements of the condition” (40-60% of the general population), and therefore can ALSO benefit from some of the top 5 techniques below.
After meeting with a professional to determine if you meet the formal criteria for ADHD (or VAST) according to Hallowell and Ratey’s description)…
Step 2- Learn about Hallowell and Ratey’s top 5 strategies in managing ADHD/VAST in their newest book, ADHD 2.0:
Exercise, cerebellum connection, stellar environments, relational connections, and medication
What are some of the benefits of exercise for ADHDers? According to Dr. Hallowell and Ratey:
For getting and staying on track, exercise is one of the most powerful non-medical tools we have… It prepares the brain to expand, learn, and change better than any other human activity. It improves mood and motivation, reduces anxiety, regulates emotions, and maintains focus… From depression to anxiety as well as for ADHD and VAST symptoms, exercise is just what the doctor should order.
How much exercise do we need to experience the above benefits?
In a 2018 research paper in Spain that reviewed a range of studies (more than 700 individuals from 8 countries) using exercise to treat ADHD, the researchers found that just 20-30 minutes of moderately paced exercise allowed:
- participants to switch gears to focus with greater strength and accuracy
- 65% of the people significantly improved their planning and organizational skills
How does exercise positively impact our brains?
In a nutshell, Hallowell and Ratey explain: “Remember, the frontal cortex is the CEO of the brain. When you get yourself moving, this area is “sparked”, turning your attention system on and allowing you to stay focused and on task.”
What is Hallowell and Ratey’s general advice on getting moving?
We recommend that you do some sort of physical activity for at least 20 minutes every day. Make it fun and interesting, and something you will want to do again… Over the course of the week, vary what you do; different activities stimulate different parts of the brain. Of course, for those of us with ADHD, novelty is important for other reasons, since boredom is our archenemy.
2. Cerebellum stimulation (balancing)
Hallowell and Ratey found that improved cerebellar function = improved ADHD symptoms.
They reference the research findings of Jeremy Schmahmann, a professor of neurology at Harvard medical School and a doctor at Massachusetts General Hospital, as well as other MRI studies that show that the central strip down the midline of the cerebellum… is ever so slightly smaller in people who have ADHD. They concluded that:
Stimulating and challenging the cerebellum, the way lifting a weight stimulates and challenges a muscle, might help reduce the negative symptoms of ADHD…
Hallowell and Ratey explain that, “An obvious way to improve vestibular health and possibly increase cerebellar strength is to work on one’s BALANCE [and coordination]… The idea that using balancing exercises can help ADHD (& dyslexia) has been in the air for decades.” Below are three different programs with this goal:
1.) In the 1960s- Frank Belgau, a special education teacher, invented the Belgau Balance Board, based on his empirical observation that balance and learning go hand in hand. Today his boards are available from the company, Learning Breakthrough.
2.) In 2000- Wynford Dore, an entrepreneur created the Zing Method (UK) to help his daughter who struggled with reading and consequently severe depression. This method improves: reading and writing, concentration, attention and focus levels (to stop procrastinating), memory, spatial awareness, emotional regulation, and confidence in social situations and new environments.
Dr. Hallowell endorses this program based on its success rate and good (and in some cases breakthrough!) results with some of his patients, as well as his family members. For example, Hallowell’s son improved his reading skills and his wife improved her spatial awareness skills.
After participants complete the Zing assessment, they receive a personalized series of exercises to do for 10 minutes, twice a day. The exercises increase in difficulty as the participant progresses through the program, which typically takes 3-6 months.
3.) In 2010- Robert Melillo, a chiropractor wrote the book, Disconnected kids: The groundbreaking brain balance program for children with autism, ADHD, dyslexia, and other neurological disorders and created the corporation, Brain Balance Achievement Centers around the U.S.
The balancing exercises at these centers work off Melillo’s ideas about connection and disconnection between the hemispheres of the brain. Hallowell and Ratey believe that these centers are better geared toward children with conditions like autism and more severe ADHD.
3. Create stellar environments with help from a coach
Hallowell and Ratey begin this next chapter with the topic of creating daily structure. They explain:
Creating structure isn’t something that usually comes naturally to someone with ADHD. Abiding by and learning to like it, even less so… Being free and a nonconformist is, after all, in our bones. But there is almost no more IMPORTANT and helpful lifestyle hack for us than engineering structure. Structure provides the walls of the bobsled run. Without it, you careen off into disaster.
The authors identify some elements of creating structure including: having a schedule, a “to do” list (with no more than 3 goals per day) and software to help adults with ADHD stay on track. In their previous books (ex. Delivered from distraction), they include MANY more tips on organization and structure if this is the area in which you need to improve. They also remind the adult reader of the importance of scheduling unstructured and play time for their children and themselves.
Hallowell and Ratey next list attributes of stellar home, learning and work environments for adults with ADHD, in addition to tips on nutrition, sleep, vitamins, and positivity.
I really appreciated how they encourage adults with ADHD to accept and find the right kind of help so we can thrive.
More than a decade ago, a big area of growth for me was learning new systems to climb out from the piles of overwhelming clutter and disorganization and practice new habits to keep chaos at bay. Admittedly, this required assistance from two different organizational coaches. While I am extremely grateful to the two local coaches who helped me accomplish a daunting task, I thought I would include Dr. Hallowell’s recommendations and team as well.
- Dr. Hallowell’s link to his team’s coaching services via teletherapy. Also, here are other coaching websites Dr. Hallowell endorses: ADD Coach Academy (addca.com), ADHD Coaches Organization (adhdcoaches.org), and Edge Foundation (edgefoundation.org)
- Dr. Hallowell also has created an app (that he offers for FREE) called CrazyBusy
Here is one final resource to consider in creating a successful work environment~
Hallowell’s book, Driven to distraction at work; How to focus and be more productive, is an essential book for many ADHD adults
Admittedly, I worried this book would be a chore to read, but to Hallowell’s credit (he knows his audience well :), he created such an easy to follow structure for his readers, that even an ADHDer like me wants to finish this book! Below is a brief outline:
Part I: Dr. Hallowell identifies and describes the impact of the six most common distractions at work and 10 succinct tips for OVERCOMING each of them!
The areas of struggle are:
1.) Screen sucking
3.) Idea Hopping
5.) Playing the Hero
6.) Dropping the Ball
Part II: Training your attention through harnessing the power of the body, mind, human connection, emotion, and structure.
4. Find your “right” difficult (through greater self-awareness)
Most people who have ADHD or VAST are naturally creative and original… they feel a persistent drive to build, develop, or create something, anything, from a business to a boat to a book to a balustrade. It’s like an omnipresent itch to make something.
If that itch goes unscratched, we tend to feel listless or depressed, unmotivated and at sea. If we pour our energies into something that is beneath our creative abilities, we tend to lose interest… If we find ourselves in a job that doesn’t draw on that creative strength, but instead demands a skill set we don’t have, we will falter… We need a challenge- but to find the right challenge.
“Boredom is our cryptonite.” – Dr. Hallowell
I believe the unique challenges that individuals with ADHD can ALSO cause folks with ADHD to underperform or inconsistently perform in one or more of these areas: at school, work, in personal relationships and/or in managing life’s responsibilities.
When adults with ADHD struggle in a significant area of life or underachieve (with no clear cause), it is NOT due to laziness, lack of intelligence or apathy. It is the result of having a real DSM diagnosis that requires we leverage our strengths and circumvent our deficits.
Identify your strengths- that will lead to action!
The key to pinpointing our “right” difficult is by developing an inventory of our strengths.
- See page 68 in ADHD 2.0 for a concise list of 10 questions that will help you assess your strengths.
- Another assessment (HIGHLY recommended by the authors) is the Kolbe Index. See below…
- See the “Sweet Spot” diagram below. Dr. Hallowell and Dr. Ratey recommend folks with ADHD/VAST should spend as much of our working day as possible “here” because this is where we will do our best work and be happiest doing it.
The Kolbe Index (created by Kathy Kolbe) is a MUCH more sophisticated method at finding one’s “Sweet Spot”– where we should spend most of our time and in choosing a career.
Kolbe wanted to find out why smart people aren’t more productive or creative.
After reviewing IQ and personality tests that did not provide the answer to this question, she created an assessment tool that~ unearths the unique and inborn way that each of us exerts effort or takes action.
This shows us a person’s CONATIVE STYLE (the mental faculty of purpose, desire or will to perform an action; volition). Our conative style determines what we actually DO in life.
Through the Kolbe Index, you can identify your natural strengths. When we’re able to use these “gut” instincts in making decisions, we can be the most productive, stress-free version of ourselves, in addition to improving our relationships.
On another note, because individuals with ADHD have trouble with planning, organizing, time management, executive functioning, etc. finding your “right” difficult is essential to motivation to push through your challenges.
Coaching and Delegation Helps
Also, as Hallowell and Ratey recommended in tip #3, receiving coaching by ADHD specialists for areas of needed growth and delegating/outsourcing tasks that reflect our most significant weaknesses also help individuals with ADHD maximize their strengths at work and home.
An example I use~ is paying for an online calendar for my private practice since time management is a challenge for me. This outsourcing of scheduling sessions with my clients has been one of the greatest gifts for me since it allows me to focus on the many other tasks of private practice that reflect my strengths.
On a final note for this tip~ consider the value of being OPEN to receiving help- so YOU CAN SHARE YOUR GIFTS with the WORLD. There is NO reward in struggling, failing, or being a martyr.
“Refusal to accept help is the single biggest reason for a person not to progress once an ADHD diagnosis has been made. No one is [completely] self-sufficient… We all depend on one another. The realistic goal in life is not to be independent, but to be effectively interdependent… You have to be able to give as well as get.
That’s how successful people operate.”
– Dr. Hallowell (Psychiatrist with ADHD & dyslexia, who credits his teachers, doctors and family – along with “the tools” for his success)
5. Medication- “The most powerful tool that everyone fears.”
There are many valid reasons people fear taking medication, and I was no exception. Making an informed choice requires receiving accurate information about the potential benefits and risks of taking ADHD medication. Here are just a few to consider (according to Hallowell and Ratey)~
- They work most of the time! ADHD stimulant medication has an 80% efficacy rate. ADHD medication “offers the most immediate and effective benefit of any ADHD treatment… They are a hugely valuable tool in our therapeutic toolbox.”
- They don’t cause addiction, but are commonly abused by teens and young adults. ADHD stimulant drugs are mainly used inappropriately by those not diagnosed with ADHD, & are among the top drugs abused by high school and college students. Teens who are ADHD and are not treated are 5-10 times more likely to become addicted to substances.
- They can cause unpleasant side effects. Some examples are: irritability, dry mouth, disruption of sleep, headaches, a decrease of appetite, increase of heart rate and blood pressure over time (which are minimal).
From anecdotal cases, Lana has known individuals whose medical provider prescribed a lower dose or a different ADHD medication, which reduced side effects and still experienced the benefits. Also, one helpful tip from a medical provider well versed in ADHD is that 1,000 mg of vitamin C allow stimulants to be eliminated through urine.
As with any prescription medication, it is extremely important for individuals to be closely monitored by their doctor, especially in the beginning stages.
Adults with ADHD can learn more about the risks and benefits of ADHD medications, and how these medications work in Hallowell and Ratey’s books in the resource list below, in addition to receiving education from your doctor.
Don’t forget your “Vitamin C” (Positive social connections)
Because children and adults with ADHD are likely to feel (at times) misunderstood, left out, less than, embarrassed for acting impulsively or our brains miswiring, shame for struggling or failing at tasks that everyone else seems to be able to do, and in some cases reprimanded, punished and/or feel they’re the cause of conflict in their relationships, ADHD can take a huge toll on an individual’s self-esteem.
And when individuals don’t have a positive sense of themselves, they are more likely to isolate themselves, which can further cause adverse affects since loneliness, according to Dr. Vivek Murthy, “is associated with a greater risk of cardiovascular disease, dementia, depression, and anxiety. At work, loneliness reduces task performance, limits creativity, and impairs other aspects of executive function such as reasoning and decision making.”
The healing balm, according to Hallowell and Ratey is “Vitamin C” or connection. The Grant Study that followed Harvard College sophomores throughout their lives affirmed the value of connection. The lead researcher, George Vaillant concluded,
The single most important factor in predicting health, longevity, occupational success, income, leadership ability and general happiness comes down to one four-letter word. It’s LOVE.
In this chapter (“The Healing Power of Connection”) from ADHD 2.0, Hallowell briefly shares his inspirational story of growing up in a family that was so unsafe, his A.C.E.S. (adverse childhood experience scale) score was an 8. Yet, he had a “magical and loving” relationship with his grandmother that illustrated how positive connections can be a saving grace. Hallowell credits his relationship with his “Gammy” as the reason he was able to beat the odds and “enjoy more than 33 happy years of marriage, three well-adjusted and treasured children, and 71 healthy years old at the time of this writing.”
Step 3- Develop your plan of strategies in managing ADHD/VAST with guidance from a knowledgeable professional & learn what works through trial and error:
How long will treatment take?
According to Hallowell and Ratey, “For some people the treatment lasts just a few sessions. For most people, however, it takes longer that that…The average duration of treatment for adult ADD is about three to six months.” Every individual with ADHD needs a personalized plan to fit their unique needs.
Just to clarify, while “treatment” might include some or all of the techniques above, ex. organizational coaching, there are definitely some lifestyle strategies, like exercise that they would attest are lifelong important practices, and other interventions, such as medication that are essential tools.
My (additional) Top 5 Personal/Professional Tips~
These handful of techniques have been lifesavers for me (& I am still a work in progress) in managing ADHD as an adult, entrepreneur, and parent.
1. Put a clock in EVERY room of your house (even the bathroom where big and little people can lose track of time) and a family calendar in the kitchen, in addition to a monthly and daily calendar in your office (for work events & personal ones if they occur on a week day).
Accessible calendars facilitate greater use of them and a reminder of the present day of the week! My type of ADHD causes time to be perplexing and elusive. It helps me tremendously to look at my calendar as soon as I wake up and before I go to sleep to look at what’s coming the next day.
2. Get ready the night before work and school or even a fun outing on the weekend. When I do this (make my son’s and my meals for the day and get our bags packed), the morning getting ready is ten times less stressful, even pleasant and we’re on time.
3. In an academic setting or professional presentation, sit in the front as close to the speaker as possible, and if possible take notes on a laptop/tablet. This increases focus, attention, enjoyable engagement and long-term retention. (And if I’m learning online or engaging in any task that requires strong focus, using a standing a desk helps as well.)
4. Exercise (including yoga)- every morning before work (even just 20 minutes) or a few consistent days for longer workouts, ideally including some balance exercises, and if possible additionally 5 minutes of meditating. This will decrease your “monkey mind”, increase your focus, mental acuity and emotion regulation and mood.
5. Say “goodbye” to piles by getting things done in the moment so you can immediately put away work items (versus piling them up to get to them “later”) and make sure to not go to bed without completing essential tasks- including making meals and packing a work/school bag for the following day. Also, allot time every week to organize (even just 30 minutes) items in home office and 30 minutes to declutter home items as well.
If you found any part of this blog to be helpful, please let me know! I am also open to constructive feedback and appreciative of hearing new ideas. If you are interested in learning more about how to minimize your challenges of ADHD and maximize your GIFTS, below are more resources than you can possibly wish for!
- ADHD 2.0 (2021) by Dr. Ed Hallowell, MD and John Ratey, MD
- Driven to distraction at work; How to focus and be more productive (2015) by Dr. Ed Hallowell
- Spark; The revolutionary science of exercise and the brain (2013) by Dr. John Ratey, MD (research that proves that exercise is truly our best defense against everything from depression to ADD to addiction to aggression to menopause to Alzheimer’s)
- Driven to distraction; Recognizing and coping with attention deficit disorder from childhood through adulthood (2011- updated version) by Dr. Ed Hallowell, MD and Dr. John Ratey
- Delivered from distraction; Getting the most out of life with ADHD (2005), Dr. Hallowell & Dr. Ratey
- The couple’s guide to thriving with ADHD (book by Melissa Orlov and Nancie Kohlenberger, LMFT)
- If you prefer videos, podcasts, etc. or listening to information, go to Google, Youtube, or TikTok and type in one of the authors’ names above. I especially like Dr. Hallowell’s videos.