Sometimes, I don’t know if I’m managing my ADHD effectively. After all, the right type and dose of stimulant medication should feel pretty unobtrusive. It doesn’t make ADHD’ers feel drugged, hyped up, or otherwise not ourselves. Once the novelty wears off, we don’t sit around and say, “wow, things seem awfully normal around here!”
Those of us with supportive, ADHD-literate spouses can benefit from their outside perspective. Sometimes only they can tell us when our ADHD is out of control.
As medications, hormones, and life have evolved over the years, I’ve also improved my self-observation skills. It’s an advanced-level ability. Pre-diagnosis and treatment, I had zero self-awareness.
Now I’ve identified what I call my canaries in the coal mine: little indicators that reflect the overall success of my ADHD treatment.
Observe with detachment, not judgement.
Objectivity is key to spotting canaries: observing my own behavior with equanimity and pragmatism, and not getting carried away by emotion and judgement. This has required a lot of work. We late-diagnosis ADHD’ers reach adulthood without positive language to describe our struggles. It takes time, effort, and compassion to eliminate negative self-talk and start believing in ourselves. My default reaction to falling off the wagon used to be, “this was inevitable. I can’t sustain anything good. I’ll always fail eventually.”
Now, I try to approach my life like a scientist. I observe, I keep detailed notes (ADHD and motherhood have wrecked my memory), and I try to keep my own biases at bay. When a system begins to break down, that’s a clue. I’m becoming a detective in my own life — a problem-solver, not a basket case.
My canaries: more than a stressful week.
One of my canaries is my weekly review, an every-Monday ritual that keeps me on top of active projects and open loops. I once noticed myself skipping it for weeks in a row. I eventually ended up talking to my doctor about switching medications.
Likewise, when I haven’t even opened my to-do list for over a week, something isn’t right. When I keep looking at my list, but never find anything I feel like I can do, something isn’t right.
While some of life’s details can slide during a high-stress time, others indicate a bigger problem.
Staying organized is possible — if ADHD symptoms are under control.
Staying organized is possible with ADHD — when it’s well-managed. When something slips out of balance, my previously-airtight systems begin to collapse. ADHD makes it hard to notice it happening before it’s too late. I may not feel different right away, or I may wave off red flags with excuses about sleep or a busy week.
The key, for me, has been to disconnect my emotional reaction from the content of my observation. Put-downs and criticism, directed inward or outward, stop problem-solving before it begins. Rather than figuring out how to fix the problem, our brains fixate on the problem itself, and how big and awful it feels.
When a system malfunctions, I ask why, and figure out what adjustments will fix it. Sort of like a car: what’s going to keep it safe, running smoothly, and doing what I need it to do? I once had a car that sputtered out right after starting unless I gave it a very specific amount of gas. Once it settled into a good idle, it was fine. The next owner couldn’t figure this out and thought the car wouldn’t run at all. I probably could’ve gotten several more years out of it.
Now I apply this approach to my entire life. It’s how I knew my medication changed effectiveness after having a child, and I wasn’t just suffering from so-called “mommy brain.”
When I spot one of those canaries, the early warnings that tip me off before my entire life derails, I don’t make excuses. I recognize them as canaries, not black swans. The earlier I recognize a problem, the better my chance of minimizing the damage and getting back on track.
What are your canaries in the coal mine? Have you discovered any early warning signs of poorly-managed ADHD? What do you do when you spot one?
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Love this post, and I just shared it with my husband (he has ADHD; I don’t). Have you ever written about the process between “I used to…” and “Now I….” that you describe here? I admire the effort that I know had to have gone into learning to be more objective about your canaries, and if you’ve written about it, I’d love to show that to him.
That’s a great question. I’m not sure if I’ve written about it, but I’ll keep your question in mind because I like to write about the super-nitty-gritty of getting from Point A to Point B.
In the meantime, I can link you to a few tangentially related posts and give a few general ideas.
Meditation and yoga have helped me a lot. I’ve learned to be gentler with myself, but also to remove myself from the maelstrom of Right Now. A regular yoga and meditation practice can help get you out of your own head and develop your ability to observe, rather than become swallowed up by, your current state.
At the same time, much of it feels like rote learning: practicing stopping yourself every time you catch yourself making a value/character judgement. Reframing it as a symptom, not a personal failure.
A supportive spouse can help a lot with this. I think it’s great that you’re reading about ADHD. Knowledge is most of the battle: knowing that X and Y behaviors have neurobiological roots, and treating them as such. Being able to look at the situation objectively rather than attributing it all to character flaws and personal failures.
I wrote a semi-related post about responding to setbacks here: http://adhdhomestead.net/pit-of-domestic-despair/
Hope this is helpful! Feel free to reply with any new questions I’ve created 😛
Oh, and one more important thing I forgot: the right type/dosage of medication. That was the first big thing that changed my perspective.
From the very first day I started medicating my ADHD, my whole perception of self and time changed. I was more able to step back and look at what was going on in a situation, and I also got a sense (finally) of what “normal” might feel like. You need that, in order to notice when something is wrong.
Meditation and the like has strengthened those muscles further. There’s no one magic solution. The best treatment is a combination of things, perfected over months or years.
” I once noticed myself skipping it for weeks in a row. I eventually ended up talking to my doctor about switching medications.”
“Likewise, when I haven’t even opened my to-do list for over a week, something isn’t right. When I keep looking at my list, but never find anything I feel like I can do, something isn’t right.”
Can you please write more about your personal medication journey and how you came to find the right med/dose? (if you haven’t already, i’ll keep looking).
I struggle with figuring out how effective mine is for me. I’ve taken adderall and ritalin, it calms me down, clears my mind, gives me the ability to organize my thoughts better, but I still have strong barriers when it comes to doing what I need to do. I still feel out of control of my attention in a sense. I still lack consistency and follow through, and still doing extreme procrastination.
I assumed that the adderall would give me all I need to apply more effort, but it’s still really hard. It feels like I’m trying to sprint underwater while all the strength is being sucked from my body. After reading your quote, it’s making me wonder if medication adjustments can actually treat that. I just assumed it couldn’t help me anymore and that the rest was all up to me. Maybe the dosage isn’t right yet.
Hi! I have lots to say about meds, even though few of my readers seem interested in reading about the issue here. Maybe I’ll consider writing up a Medication 101 type post, or see if I can snag a guest post from an expert. Speaking of which, Gina Pera writes a lot about medication issues on her blog, ADHD Rollercoaster: https://adhdrollercoaster.org/
But to give a brief summary here, this is what I’ve learned from my research and personal experience:
1.) Adderall is known for being less-than-ideal for many patients. It should be seen as a last resort for prescribers, something to try if other options don’t work. Unfortunately, many docs see it as a first-line option.
2.) Many experts recommend trying the methylphenidate (MPH) class of medications first. Those include Ritalin, Concerta, Daytrana, Quillivant, Focalin, etc.
3.) Whatever med you try, start with a low dose of the name brand drug. You may not feel any therapeutic effects. This is the goal. Gradually increase the dose until you get maximum therapeutic effects with minimal side effects.
4.) If that balance doesn’t exist, you have the wrong drug. If you find something that works, try the generic. Be aware that there can be a lot of variation between different generics and the name brand. That’s why it’s a good idea to try the brand first if you can — to get a baseline for the intended effect.
5.) If you want to try the AMP class of meds, many folks recommend Vyvanse, not Adderall, as a first thing to try. It’s a much more modern drug with fewer side effect risks.
Perhaps most important to know about stimulant meds in general:
1.) Finding the correct medication + the correct dosage can take a while. Starting with low doses of the name brand and gradually increasing will give you the best chance of finding that combo with minimal ill effects.
2.) The correct medication + dosage may feel like nothing to you. Definitely enlist someone close to you, if you can, to help observe its effects. You shouldn’t feel jittery, irritable, zonked out, or anything else out of the ordinary. The best thing meds did for me was open my eyes to what my baseline “normal” should look like.
3.) You’ll still need to create systems and coping mechanisms. Meds won’t make everything effortless. But they can make things feel *possible*.
Hope this helps! Obviously I’m not a doctor, so I can’t make any medical recommendations or tell you what you should do — just what has worked for me and others, and the advice I’ve read from trusted experts in the field. I’d recommend checking out Gina’s books plus the blog linked above. Russell Barkley has written some very useful material for adults with ADHD as well. If you can’t get your hands on a copy of his book Taking Charge of Adult ADHD, you can find some of his talks on YouTube. Of course, you should also search for a psychiatrist with expertise in treating adults with ADHD, but I know that is not available in all areas.