A Guide to Stimulant Medication: The most common type of medication used to manage ADHD symptoms10/14/2021
Author: Sadie O'Hara ADHD symptom management is different for each individual, but one common tool for managing troublesome ADHD symptoms is stimulant medication. The purpose of this article is to provide some information about stimulant medications, and to address some common myths surrounding stimulants. You may be wondering, what are stimulants? Stimulants, also known as psychostimulants, are a class of medications that stimulate the central nervous system (CNS). Most people are familiar with stimulants such as caffeine and nicotine, which generally make one feel more alert and energetic. With hyperactivity being a primary feature of ADHD, stimulant medication can seem counterintuitive. However, for those with ADHD, stimulant medications have been shown to reduce distractibility, improve sustained attention, reduce impulsive behaviors, and improve activity level. To understand how stimulants might achieve these effects, we need to consider what is already known about ADHD. We are still learning about ADHD, but current evidence suggests that many symptoms may be related to levels of dopamine and norepinephrine in the brain. Dopamine and norepinephrine are two molecules used by the nervous system to transmit messages. The level of dopamine and norepinephrine in the brain can impact a person’s mood, attention, motivation, and movement. Dopamine and norepinephrine also play an important part in the brain’s reward system. Experts believe that people with ADHD have an increased number of transporters that remove dopamine and norepinephrine, leading to decreased levels. Stimulant medications are believed to increase the availability of dopamine and norepinephrine in the brain. This can be achieved in different ways, such as by slowing down the removal of these neurotransmitters or by increasing their release. This increased availability allows dopamine and norepinephrine to properly bind to receptors and transmit their message more effectively. This is an extremely simplified version of how stimulant medications produce their effects. It is beyond the scope of this article to fully explain the various proposed hypotheses on the neurobiology of ADHD. For more information please see the referenced article Neurobiology of ADHD: A Review, and other sources cited blow this article. A few stimulant medications are most commonly prescribed for ADHD: methylphenidate, amphetamine, and lisdexamfetamine. You may know of methylphenidate by a brand name, such as Ritalin, Concerta, Daytrana, Metadate, Methylin, Quillivant XR, or QuilliChew ER. Amphetamine is often combined with dextroamphetamine and sold under the brand name Adderall. Lisdexamfetamine brand name is Vyvanse. You may notice some medications have ER, SR, XL, XR, or CD after the name, this means the medication is an extended-release medication. These medications are different from immediate-release medications which are are formulated to release the drug immediately after it is taken, causing a rapid onset of effects but a shorter duration. Stimulants have been available in immediate-release formulations for over 60 years, but can cause more side-effects and require multiple doses each day. Extended-release formulations have been developed more recently to decrease side-effects and increase convenience. These medications often contain the same active drug ingredients as previously used immediate-release medications, but the extended-release formulation allows the drug to be delivered in a more controlled manner. Generally, extended-release medications are designed to work in phases. Some of the drug is released shortly after you take the medication and the rest is slowly released over 6-12 hours, depending on the medication. One benefit of extended-release formulations is that they can offer symptom relief all day with just one pill. They also cause fewer ups and downs throughout the day. Of the stimulant medications, response to a specific drug is highly variable with some people responding better to one drug than others. For some people, an immediate release stimulant may be prescribed in addition to the extended-release stimulant to relieve symptoms in the morning or evening. Common side effects of stimulant medications can be managed with dose adjustments or may diminish over time and can include: sleep problems, decreased appetite, weight loss, increased blood pressure, dizziness, headaches, stomachaches, nervousness, moodiness, and irritability. Liquid, chewable, sprinkled capsule, wearable patch, and orally disintegrating tablet formulations are also available for people who may have difficulty swallowing traditional pills. The dose of a stimulant medication required for optimal symptom reduction with minimal side effects also varies greatly from person to person and will likely have to be adjusted. It is important for people with ADHD to communicate with their healthcare provider so that dosages and formulations can be adjusted to achieve optimal symptom reduction. There have been numerous studies demonstrating that stimulants are an effective and safe way to manage troublesome ADHD symptoms, however myths surrounding stimulants to be prevalent. This section will address some common myths. Myth: ADHD medications cause drug and alcohol abuse Fact: ADHD medications do not cause drug and alcohol abuse Studies have found that people with ADHD are at high risk for alcohol and drug use misuse. Because of this, some reports have suggested that drug use was caused by treatment with stimulant medications. However, studies have found that treating ADHD with stimulant medications can significantly reduce one’s risk of substance abuse or dependence. Myth: ADHD medications are addictive Fact: The therapeutic use of stimulant medications for ADHD can help prevent addiction Stimulant drugs are potentially addictive but their ability to cause addiction depends on how they are used. There is no evidence that using oral, therapeutic doses of stimulant medication leads to addiction. Myth: Stimulants make you aggressive Fact: Stimulants are able to reduce aggressive and antisocial behaviour Myth: Stimulant medications are overprescribed Fact: ADHD remains under-recognized, under-diagnosed, and under-treated even though it is the most treatable psychiatric disorder in Canada It is important to note that approximately one third of people with ADHD do not respond adequately to and/or tolerate stimulants. For individuals who cannot or do not wish to take stimulant medications, nonstimulant ADHD medications are a secondary option. People with ADHD can benefit from a wide variety treatments other than or in combination with stimulant medication such as behavioral and psychosocial treatments. A friendly reminder: The content in this post is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. References Brown, K. A., Samuel, S., & Patel, D. R. (2018). Pharmacologic management of attention deficit hyperactivity disorder in children and adolescents: A review for practitioners. Translational Pediatrics, 7(1), 36-47. https://doi.org/10.21037/tp.2017.08.02 Caye, A., Swanson, J. M., Coghill, D., & Rohde, L. A. (2018). Treatment strategies for ADHD: An evidence-based guide to select optimal treatment. Molecular Psychiatry, 24(3), 390-408. https://doi.org/10.1038/s41380-018-0116-3 Mattingly, G. W., Wilson, J., & Rostain, A. L. (2017). A clinician’s guide to ADHD treatment options. Postgraduate Medicine, 129(7), 657-666. https://doi.org/10.1080/00325481.2017.1354648 Mehta, T. R., Monegro, A., Nene, Y., Fayyaz, M., & Bollu, P. C. (2019). Neurobiology of ADHD: A review. Current Developmental Disorders Reports, 6(4), 235-240. https://doi.org/10.1007/s40474-019-00182-w Author: Georgia Macdonald-DanversThis article is for all of my neurodivergent friends who menstruate. 'Aunt Flow' is notoriously the least favourite visitor of every month, with the cramping and the PMS. But for people with ADHD, it is a whole other problem. PMS is often not an experience people with ADHD have, instead it usually manifests as premenstrual dysphoric disorder (PMDD). PMS and PMDD share symptoms of; breast tenderness, bloating, change in appetite, mood swings, low concentration, and over 150 others. Where PMS and PMDD differ is that PMDD is a bit more strict in the diagnostic criteria. While it is separate from other mental disorders as it is directly linked to menstruation, PMDD specifically is distinguished by an abundance of symptoms, one of which has to involve mood dysregulation. Aside from symptoms, the intensity of them must be causing functional impairment. So, when we think of PMS, that is the typical light cramping and hormonal moodiness that can come before your period. PMDD is a hormone-related mood disorder (another example of a hormone-related mood disorder is postpartum depression). To begin, mood-related symptoms are already more common for women with ADHD (often experiencing more anxiety & depression). This puts neurodivergent women at especially high risk for this disorder. In a study, they found that 45.5% of women with ADHD experience PMDD versus the 28.7% prevalence rate in the general population. The symptoms of PMDD spread beyond the week of a period. Often symptoms are between weeks 2-4 of your menstrual cycle, making it an incredibly overwhelming and somewhat long-term problem almost if not every single month. The diagnosis process of PMDD is simple but long. To be able to accurately diagnose this hormonal mood disorder you need to have a very complete examination of your mental and physical health. For diagnoses, it is important to have recorded medical history, lab assessment, and pelvic examination. The medical history should be detailed and also should include any previous or current medications to be able to take substance abuse into account. In the lab, your hormone levels, blood chemistry, and cell count can be looked at to give more insight into your patterns and symptoms. Along with these, a pelvic exam is required as it is important to look for and rule out any other physical illness. There are many ways to treat or more so manage PMDD symptoms. SSRIs like Zoloft can be used to treat the issues with mood associated with the disorder. Professionals recommend lifestyle changes to assist in being able to cope with PMDD. These include; dietary changes and supplements, regular exercise, and keeping stress levels as low as possible. Sources: Expert Guidelines for the Treatment of Severe PMS, PMDD, and Comorbidities: The Role of SSRIs by Meir Steiner, Teri Pearlstein, Lee S. Cohen, Jean Endicott, Susan G. Kornstein, Carla Roberts, David L. Roberts, & Kimberly Yonkers Prevalence of hormone-related mood disorder symptoms in women with ADHD Farangis Dorani, Denise Bijleng, Aartjan T.F. Beekman, Eus J.W. van Someren, J.J. Sandra Kooij Understanding and treating PMS/PMDD by Penelope M. Bosarge Author: Allison Cooke // CW: Disordered Eating Unfortunate as I was to discover that commonality of comorbidity of mental illnesses, the relation in symptoms leads to a relation in treatment, meaning although one problem may be presented in different ways, the aid is also found in one way but can be applied to a variety of symptoms. Personally, I survive through a diagnosis of Bipolar II disorder and generalized anxiety, as well as ADHD which this article pertains to, however an illness I have not been officially diagnosed in is Anorexia Nervosa. The concept of diagnosis in the mental health field as a way of validation of sickness is privileged in the simplest of terms. The accessibility of a doctor capable of diagnosis is not universal even within a singular country or in my case the particular province I live in. I identify as surviving through both ADHD and Anorexia Nervosa. I do not need a doctor to tell me, and validate that I have significant problems with eating. Due to the physical ramifications of an eating disorder, a self-diagnosis is accepted as fact. In general, studies have suggested that there is a significant gendered factor to Eating Disorders, including the entire spectrum from Bulimia Nervosa to my own self-diagnosis of Anorexia Nervosa. On the topic of gender and following the topic of diagnosis is the matter of a huge population of girls and women who remain undiagnosed with ADHD due to the DSM-5 criteria and its bias towards symptoms that fall more on the male side of the disorder. Studies have shown the current levels of ones ADHD, recognizing that symptoms can at times be much more prevalent than other times, are fasting related. Furthermore, the concept of a peak in ADHD behaviours can be related to feelings of impulsivity and a general lack of control that can come to prevalence regarding food and consumption. Binge eating, which is characterized as consuming a large quantity of food in a short period of time, is closely related to the impulsivity that is so recognized as a part of ADHD. The logic behind this relates to the hyper-focus on a particular topic that accompanies a lack of concentration of a subject unrelated to the particular fixation, resulting in an intended or unintended fast; the body responds when finally given the fuel it was deprived of by consuming all within sight. From my personal perspective, I understand that controlling my impulsivity plays a role in my eating disorder. I find peace in the control I take over my ADHD mindset and predisposition to binge eating by starving myself of not only nutrients by joyous foods and food-related activities. Generally speaking, the activity of eating is a break for most people, with their lunch break signifying a rest time during the workday. My mind has two functions; stop and go, meaning I have a hard time stopping an activity for a break to eat, and fall into holes of restricting and bingeing. On the eating disorder side of this comorbid combination is a dreadful shame that accompanies the binges, and fuels my desire to prolong the restriction phases. This is a spiral that the longer you restrict, the less control you have when you finally binge, and then the eating disorder voices tell you to compensate by restricting longer and harder, only to inevitably trigger another binge. This may look grim, but one of the benefits of comorbid illnesses is the treatment is also comorbid, or occurring at once. With treatment of my impulse control, I can target both the ADHD and ED behaviours. Furthermore, in relation to eating disorders, there is no medication that will cure you, however in my opinion eating disorders are commonly a symptom, or better phrased a coping mechanism to another illness, meaning that the impulsivity that enables binge eating can be treated on its own, and thus have a positive effect on the binges, although not directly treating. It is important to remember that eating disorders are mental illnesses and cannot be treated through physical means alone, meaning treating the psychological symptoms will result in physical benefits, like better coping strategies than starving yourself for control. Sources: Ptacek, Radek et al. “Attention deficit hyperactivity disorder and disordered eating behaviors: links, risks, and challenges faced.”Dove Press Journal Neuropsychiatric Disease and Treatment. 2016. Sala, L et al. “Attention-deficit/hyperactivity disorder symptoms and psychological comorbidity in eating disorder patients.” Eat Weight Disord. 2018. Yao, Shuyang et al. “Associations Between Attention-Deficit/ Hyperactivity Disorder and Various Eating Disorders: A Swedish Nationwide Population Study Using Multiple Genetically Informative Approaches.” Society of Biological Psychiatry. 2019. Author: Georgia Macdonald-Danvers Welcome back! After an (unplanned) hiatus we are back with all of the information you love. This time, we're talking about interests and hobbies! This topic is one I have been wanting to dive into for a while since interests can be so complex for the ADHD mind. To start, let's talk about hyperfocus. Think about those times where you're sitting down to work on something, after a few minutes when you decide to stop you look up to realize those few minutes were actually HOURS, when you need to learn everything there is to know about that new thing you are interested in. Those are the moments of hyperfocus that impede the life of people with ADHD consistently. This is a term that is going to be important when thinking about interests and hobbies (and everywhere else, loved ones should take note of this one). Hyperfocus is an ADHD symptom that can be described as long-lasting and highly focused attention. It can even be described as falling into a hypnotic spell. Through research we have seen that hyperfocus is most commonly brought on by hobbies, being on a computer, and watching TV! Something to note for women and girls with ADHD, we are more likely to feel the need for perfectionism, a less than ideal accompaniment with hyperfocus. Next, we get to talk about 'Hobby Jumping', which manifests itself in women with ADHD incredibly often. 'Hobby Jumping' is the tendency for people with ADHD to move from or collect multiple hobbies at a rapid pace. This often looks like a cycle of gaining interest, lots of research, hyperfocus (or the hobby becoming a hyper fixation), to then be left feeling uninterested and bored once again. If you're neurotypical and reading this, that is right, most people with ADHD are gaining and losing passions for things all the time. This symptom has been looming in the back of my mind since the day I started ADH-She. I love this site and I am afraid of waking up one morning to lose the spark I feel for it now. In saying that, it's been a wonderful few months of growing and although I have moments where I think I may want to give it all up I feel as though this is a project that will stand the test of time (unlike when I wanted to be an actress, influencer, baker, or learn the ins and outs of making jewellery). I say that because although jumping interests can be hard and can feel like nothing will ever truly stick, but that is not always the case! So, whether you're on hour 6 of your favourite video game or spending your days researching the mysteries of outer space... the world of hobbies, interests, and hyper fixations are for everyone (especially in the ADHD community)! Continue to share your art, knowledge, and skills with the world around you, even if that project never gets finished or if that topic starts sounding boring. There is no shame in being passionate about something right here, right now! Sources: Living "in the zone": hyperfocus in adult ADHD by Kathleen Hupfeld, Tessa Abagis & Priti Shah ADHD in Girls: Why It's Ignored, Why That's Dangerous by Maureen Connolly & reviewed by Sharon Saline, PSY.D Understanding ADHD in Girls: Identification and Social Characteristics by Janice Grskovic & Sydney S. Zentall Author: Georgia Macdonald-Danvers Often, when looking at symptoms of ADHD, we expect the "hyperactive rule-breaker" that is associated males. But, have you ever noticed you or your loved one has less control of their emotions, has regular mood swings, and is easily irritated? Well, that is the hallmark ADHD symptom of emotional dysfunction. As someone who struggles with this symptom personally, it is not as intimidating as it sounds. Emotional dysregulation can be defined as the inability to control emotional responses to stimuli. It is especially common among adult women with ADHD, so this is an important topic to cover over here on ADH-She. Researchers also often equate emotional dysregulation with emotional impulsivity which is characterized by; lack of patience, a quick temper, overreaction, becoming excited with ease, and being easily irritated. These symptoms of impulsivity are also prevalent in women with ADHD, making emotional dysregulation something that can become a more impairing issue (example: unhealthy coping). First, advice for my neurodivergent friends! Below are some tips on how to manage emotional dysregulation in your own life: 1. Check your Facts!: ask yourself these 4 questions when you feel things are escalating emotionally; "what event triggered my emotion?", "what interpretations or assumptions am I making about the event?", "does my emotion and its intensity match the facts of the situation?", and "does my emotion just match my assumptions of the situation?" 2. Focus on positive activities & events: examples of small positive activities are having a nice meal, visiting a friend, listening to music, or going on a walk! 3. Be prepared!: dreading the possibility of entering a situation that might be a bit emotionally stressful? Make an escape plan to ensure whatever emotional triggers arrive, you can distance yourself. Another way to be proactive with emotional dysregulation is to schedule times to vent and recharge! Next, for the support system (you're so important) there are some things (and advice) you can do for your neurotypical loved ones to make their experience even easier: 1. Your loved one ≠ their emotional response: emotional challenges come from your brain, and the ADHD brain has some difficulties with brain connectivity networks that are in charge of carrying emotional information. Remember that although these outbursts may be challenging for you both, they are not representative of your loved one. 2. Allow your loved one to feel safe: often emotional outbursts can be a sign that something is being perceived as emotionally dangerous (even if that is not the reality). This perception is what brings on the 'fight or flight' response we so classically know leads to outbursts and RSD. 3. We need you: not only does ADHD require multiple forms of support, but a positive support system helps build emotional resilience. As well, having a present support system can build emotional security. The people around us play a massive role in the journey to controlling emotions. In all, feelings happen to everyone! For my fellow ADHD'ers, a massive challenge can be figuring out how to regulate our own emotions and reactions. Self-work mixed with the support of loved ones can alleviate the stress and minimize the impacts of emotional dysregulation. Sources: Emotional Dysregulation from the Psychology Care & Healing Center Is emotional dysregulation part of the psychopathology of ADHD in adults? by Salvatore Corbisiero, Rolf-Dieter Stieglitz, Wolfgang Retz & Michael Rösler How to Deal with Emotional Dysregulation from Alvarado Parkway Institute 21 Emotion Regulation Worksheets and Strategies by Courtney E. Ackerman, MA 9 Tips for Managing ADHD Mood Swings reviewed by Timothy J. Legg, PhD 7 Truths About ADHD and Intense Emotions by Thomas E. Brown PhD Author: Lori MacIntyre My journey as the mom of a girl with ADHD began about 6 months ago, when out of the blue, my 16 year old daughter told me something was wrong – she was having trouble focusing. We booked a visit with our family doctor, and were given some questionnaires for my daughter, her teacher and I to complete before the appointment. Our doctor reviewed the results of the questionnaires and she was diagnosed with ADHD the same day. She left with a prescription for ADHD medication. I was actually a little bit shocked with the speedy diagnosis, but she started the medication the next day, and she noticed some immediate improvement in her ability to focus. In fact, she said she finally felt “normal”. We also got busy working with school staff to put into place a customized learning plan to ensure her learning needs were met in the classroom setting. Both the meds and the IEP have needed some tweaking over the past several months, but things are moving in the right direction. Since the diagnosis, we have been on a steep learning curve to understand ADHD, especially how it manifests in women and girls. My knowledge of ADHD was limited to begin with. What little I did know about ADHD was about symptoms observed most often in boys who can’t sit still or act out in school. I was completely unaware that the behaviours that I had been observing for years in my daughter were actually symptoms of ADHD. When I think of the comments teachers consistently made over the years, I am stunned at the lack of awareness that even educators have on ADHD in girls. She is textbook inattentive ADHD type. Never once did any teacher suggest that my daughter should be assessed. In fact, there were a lot of negative value judgments placed on her ADHD symptoms by teachers, and I am sure this impacted her own beliefs about her potential for academic success. I have since learned a lot about the inattention aspect of ADHD, and how easily confused these symptoms are with negative behaviours such as disorganization, forgetfulness, laziness, poor follow through, etc. When I reflect on my response as a parent to what I know now are ADHD symptoms, I realize now why my approach to addressing these behaviours was wholly ineffective, and in fact, negatively impacted my relationship with my daughter. I know that my lack of awareness about ADHD lead to me holding my daughter responsible for behaviours she did not understand and could not control. How much pain and conflict between us could have been avoided had I known then what I know now? How many years of academic achievement could have been better supported if I had understood and advocated for teachers to adequately meet her needs? As they say, when you know better, you do better. I offer a few suggestions which have really helped me along this journey so that I can better support my daughter –
Author: Georgia Macdonald-Danvers | Content Warning: Death, Loss, Mental Illness This piece is a personal account of my experience as a neurodivergent individual experiencing the loss of my Nana, Marlene May Betty Danvers (1944-2021). My Nana was such a kindhearted woman, she never had the chance to see what I am working on over here but I know she would be proud of the hard work and passion going into this project. I hope there is someone out here who can read this, relate, grow, and learn alongside me. Hi friends, it has been a while. Just as this journey began, I had to take a break. At first, that was hard for me to swallow, as this has been the current thing I have been hyper-fixated on. At first, I wanted to keep pushing and working, but as I account for the last few weeks of my life you will see how that did not go as planned. This story starts before ADH-She was even thought of. To be transparent, this starts before my diagnosis and that makes my timeline especially blurry. So we'll start from where I know when this website was started. At that point, my grandmother's health was declining during her fight with lung cancer accompanied by Chronic Obstructive Pulmonary Disease. My Nana Marlene was a glowing woman and one of the greatest people I have known, I loved to laugh with her and the parts of her I see in myself I hold near and dear. Getting the news that someone you love is passing is never easy, but the symptoms of a neurological disorder can impact the experience. Not only was the grief already started, but the anxiety around this massive negative life change I could see ahead was setting in and only getting stronger. This led me to work and plan constantly for what I was so afraid of, my life is forever changed. I was in a constant rush cleaning, reaching out to my University just in case, anything I could to feel like nothing bad was going to happen or that I was "ready" for something that I couldn't even understand. This is what I see now (after a chat with my therapist... if you don't have one, get one) as compartmentalizing my pain, the reality of my situation was that my grasp for control was a tool to distract and it worked. There was a point and time where I would get into such a deep space of hyperfocus I would forget what was happening a few hours away. These symptoms of hyperfocus and coping are not uncommon especially in a female with ADHD. I felt a lot of guilt when I would sit down at the end of the day to realize I was not even thinking about how anyone was doing. In saying that, I had to become more aware that these feelings that were surfacing were unlike anything I have ever felt as this was my first experience having to even think about losing someone so close. That grief can weigh heavily and can make your thoughts so overwhelming. So, my mind shut them off. My subconscious changed my priorities and thoughts and I was working hard, until April 22nd. The morning was like any other, I had actually just arrived at a shift at my job. When I say the moments in and around receiving the phone call about my Nana were a catastrophe, that is an understatement. All of a sudden the medication I had just taken to help with my mood, focus, and wellbeing were deemed ineffective, my support system was at home, I couldn't even think. For anyone in this situation, all you can do is reach out and try your best. All I could think to do was call my mom. We talked until I gained some composure so I could get myself home from the shift that never even started. I think this is a part of the story I want to tell because it highlights why sometimes even hearing the voice of a loved one can change everything. The rest of that day is not something I can share, I wasn't really there. In the context of my ADHD, dissociating was not a great experience. I have found the space between all of that time to be upsetting and confusing even now that I have moved past that feeling of mental "blackout". That feeling was not incredibly familiar to me and I still am trying to understand. I guess this means we've entered the aftermath, what happened after and what I am doing now. I still feel negative feelings towards myself I am trying to combat for the time leading up to the funeral, I stayed in my ignorant bliss, pushing things aside, and continued working in isolation. Afterwards, I had (what I consider to be) the worst streak of Rejection Sensitive Dysphoria I had ever faced, which was another symptom I did not expect to come out of this. I'll spare the details of the outburst, but the lesson learned was that sometimes you cannot predict or control how something will make you feel. That may not seem encouraging, but the comfort I have found is that I tried, am still trying, and not every situation is a success especially when dealing with conflict regarding mental health. I tried my hardest to be the best friend, family member, peer that I could and although a bridge was burned in the process, that may not have been the bridge that was meant to support me. For me, this wound is still so fresh, I still feel so much. Writing this piece is the first time I have sat down and thought about what happened over these last couple of weeks. Working through my ADHD symptoms and how they connect to this mourning process is still incredibly new for me as well. So I wanted to break my (almost) month-long silence by writing this. I did not know where it was going when I started typing this morning, but what I did know is I am not the only one who has had to feel this way. Being thrown into this emotional upset was not easy, but it wasn't meant to be. These hard times are the times where I feel like I want to spread knowledge even more. I want to share my hardships and pain that has lead to beautiful life lessons or at least silver linings within the darkest clouds. To those who have made it to the end of this post, thank you. I hope even if it is not in the most direct sense, you can be touched by or take a lesson from the story I shared today. Author: Georgia Macdonald-Danvers "You should try yoga!" ... "you might be able to do more if you practice self-care." If you're like me, these is the most frustrating phrases to hear when speaking about mental challenges. But, I will give credit where credit is due, mindfulness is a wonderful tool when combatting the symptoms of ADHD... especially for women! There have been studies that suggest that women are actually more interested in and find more success in mindfulness techniques in treating the mood and emotional irregularity symptoms associated with the disorder. Mindfulness is rooted in Buddhism and focuses on observation and being present. In the context of mental illness/disorders (us!) mindfulness focuses on non-judgement and being present to be able to regulate our emotions and other symptoms or sensations we may feel (yes, mindfulness can help with hyperactive, impulsive, and emotional symptoms alike). The point is presence and awareness can allow you to, in simple language, separate yourself from your symptoms and work through them. Now that we have the basics, here are a few techniques you can use to practice mindfulness on your own! Square/Box Breathing: This technique is a personal favourite of mine. Square breathing uses guided, deep, slow breaths to bring down stress levels and heighten your concentration. Begin by taking a deep breath out, trying your best to empty your lungs, this is always where you start with controlled breathing. To begin the 'box' style of breathing that makes this technique all it is; inhale to a count of four focusing on how the breath is filling your lungs and expanding your belly, next hold that breath for a count of four, finally release for a count of four and continue. While doing this 4x4x4 breathing technique pay attention to the decrease in your heart rate as well as the rise and fall that comes with each step. Body Scanning: This technique is perfect for my sisters that struggle with physical and mental hypersensitivity (I feel you!). The goal here is to be aware of the sensations in your body, become familiar with them, and learn to manage them, so practice is key (I recommend practicing it as much as you can throughout your day). Start by getting in whatever position and environment that is most comfortable for you, next take some deep breaths (maybe even some square breaths?), start at the tips of your toes and slowly start becoming aware of the sensations that may arise, breathe into any that are uncomfortable and continue to bring your attention to higher points throughout your body. Focus on breathing through tension and uncomfortable sensations and becoming aware of them to be better equipped when dealing with these things overtime. Yoga: The one you've been waiting for... the one your "Karen" of an Aunt keeps sharing with you on Facebook... the only form of excise I like... it's yoga! Although that introduction may have felt negative, yoga has been a powerhouse of favourite as far as mindfulness and Western culture and wellness, and with good reason. Yoga brings forth my favourite parts of exercise and meditation to create this holistic experience that can be so amazing for people with ADHD. Combining stretches, movements, and deep breathing the hyperactive and scattered mind of a women with ADHD gets a workout. Whether you're utilizing video style guided yoga on YouTube or Apps, going to classes, or making up your own poses and practices yoga can be a beneficial way to become in tune with your body and work off some of that excess energy you may be feeling throughout the day all at once! When it comes to being mindful... you can be your own guide! Practicing new techniques and expanding your "big book of strategies" is a great way to learn what ways work for you and what does not (plus, we both know doing the same breathing technique day-in and day-out gets boring). So developing your own set of strategies to be mindful is a great step at becoming better friends with your ADHD. Sources: Mindfulness vs psychoeducation in adult ADHD: a randomized controlled trial by Hoxhaj, Sadohara, Borel, Amelio, Sobanski, Muller, Feige, Mathhies, & Philipsen (2018) The Effectiveness of Mindfulness-Based Therapies for ADHD: A Meta-Analytic Review by Cairncross & Carlin (2016) Author: Georgia Macdonald-Danvers My fellow ADHD-er's! Do you ever feel like everything and everyone is against you? That any time you speak someone is going to react with hostility and judgement? Are you getting anxious, upset, or even angry at those around you? You are definitely not alone in this experience, you're having rejection sensitive dysphoria (RSD). Let's start with the basics. What is RSD? It can be defined as; "the disposition to anxiously expect, readily perceive, and intensely react to rejection". The disappointing reality for the reading this is, not only do women experience higher rates of rejection sensitivity but also teens and adults with ADHD. So, majority of the people here reading this has experienced this feeling at least once. Now, the former paragraph was not to downplay the experience of rejection sensitivity, in fact 1 in 3 people describe it as the hardest part of the disorder. Instead, I want to prove to all of you that although it is a struggle, you are not struggling alone. RSD can look different for everyone! Some signs of RSD include:
Now that the facts are laid out, here is my first hand experience and advice on how to manage RSD & how to navigate relationships that involve RSD. Since there are no clear therapeutic methods to resolve rejection sensitivity, there has to be some work between the individual with ADHD as well as the counterpart in the relationship. First, let me address my fellow ADHD-er's. RSD is something that will occur sometimes but your thoughts, feelings, and actions will never be a genuine representation of yourself and your character. In a more clinical sense, your rejection sensitivity is your nervous system overreacting, setting off an extreme stress response. This is something you cannot control in the moment. Two things that can help you reduce your symptoms of RSD (1) take time to work on emotional regulation to be able to deal with rejection in a healthier, and positive way. (2) Practicing self-care and no... I am not saying you have to throw on a face mask and do the typical "self care day". Making sure your necessities are taken care of (sleep, diet, exercise) is equally valid as self care. Making sure you are at your healthiest can reduce your stress levels and reduce your chances of a "RSD episode". For the loved ones, my only piece of advice to you is to watch for these symptoms. Being aware of when these behaviours and symptoms arise can help you practice patience. Take a moment to remind yourself that this is not your loved one reacting, it is your loved one's condition and their perceived notion that you are upset with them, leaving them, or going to hurt them. Although you may not be met with immediate trust, a simple affirmation of reassurance can be extremely helpful. Some examples are;
Sources: Rejection Sensitivity and the Rejection–Hostility Link in Romantic Relationships by Rainer Romero‐Canyas, Geraldine Downey, Kathy Berenson, Ozlem Ayduk & N. Jan Kang (2010) Rejection Sensitivity and Depressive Symptoms in Women by Ozlem Ayduk, Geraldine Downey & Minji Kim (2001) What Is Rejection Sensitive Dysphoria? Reviewed by Smitha Bhandari, MD (2020) Author: Georgia Macdonald-Danvers If you're here, you likely have a loved one with Attention Deficit Hyperactivity Disorder (ADHD). As a neurodivergent woman myself, I thank you for your willingness to learn. As a friend, partner, family member, your support can be crucial for the women and girls in your life with ADHD! To be transparent, I was not sure how to format this. The plan I have gone with is listing three (3) functional problems and impairments from the promised professional sources followed by suggestions on how you can help your loved one from the author herself!
Like you, us females with ADHD are also learning how to adapt, work around, and accommodate for our disorder. I think overall, that this a key thing to remember throughout your relationship with the female. No relationship is perfect and often there are days where your support may miss the mark or not be what the other person needs, but that is a time where you both can communicate what works better for you as a pair! Although this can be used as a resource, every person looks different, so take a moment to ask how you can best support the person you love! Sources: Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/hyperactivity disorder in women and girls from BMC Psychiatry (2020) Rejection Sensitivity and Depressive Symptoms in Women by Ozlem Ayduk, Geraldine Downey, & Minji Kim (2001) |