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Key points
- In helping someone with ADHD it is important to remember to treat the individual rather than the symptoms.
- People with ADHD tend thrive in structured environments.
- Sufficient sleep, well-balanced diet, regular exercise, and social support, can improve ADHD.
Children and adolescents are often referred to my practice to help cope better with their attention deficit disorder. As I described in a previous blog, there are many treatments available for patients with ADHD including cognitive behavioral therapy, hypnosis, instruction in anger management, and stimulant or cognition-enhancing medications.
This blog will focus on how people with ADHD can be better helped by their families, friends, teachers, and employers.
1. ADHD Is a Gift
Often, people diagnosed with ADHD think of themselves as abnormal, disadvantaged, or bad. This can occur because sometimes they have been told repeatedly that their inability to pay attention is because they are lazy, unable to control themselves, or willfully disobedient. This can lead people to lose self-esteem, become anxious, or even depressed.
To help improve their self-doubt, I explain that having ADHD is a gift because it allows their mind to easily go many places and thus enhances their ability to be creative and think “outside-of-the box.” ADHD also gives them the ability to hyperfocus on something of interest to them, which can help them become much more productive in certain situations.
ADHD is only a “disorder” if it interferes with their lives, such as when they act impulsively, or lose focus when it would behoove them to pay better attention, such as at school or while performing some job responsibilities. However, I explain that once people control the negative aspects of their ADHD, they have significant advantages over people who do not have it.
2. Support the Person
In helping someone with ADHD it is important to remember to treat the individual rather than the symptoms.
Addressing the individual starts with listening carefully to their characterization of their challenges. Do they have trouble controlling their impulses? Do they have trouble focusing in school? Do they become distracted easily? Do they feel as if they might never improve?
If observers of the individual (e.g., teachers, parents, or co-workers) believe that certain of their ADHD-related behaviors are problematic, it is essential that the individual assess whether they agree, and if they are willing to work on improving these issues. Their supporter needs to remain patient during this process, with an understanding learning how to manage ADHD can involve many trials and errors.
Supporters who want to give verbal instructions to people with ADHD who are in a hyperfocused state should first address them by name to capture their attention. Otherwise, a hyperfocused individual is apt to appear as if they are ignoring instructions simply because they do not hear them.
To help affected individuals feel and function better, supporters should provide a lot of positive feedback regarding improved behaviors, rather than spotlighting undesirable characteristics.
People with ADHD who are treated with medications often report discomforts related to side-effects from the accompanying changes in their brain chemistry. Supporters can help reassure them that most medication side-effects improve with time. If this does not occur, the treating clinician might be asked to consider switching to a different kind of ADHD medication.
3. Provide Structure
People with ADHD tend thrive in structured environments. Such structure includes:
- Creating and maintaining routines can help develop habits of accomplishing tasks effectively.
- A quiet environment without distractions can be very helpful. This includes silencing cell phones or putting them in another room, or provision of noise-cancelling headphones. In a classroom this might mean allowing a student to sit away from others, including sometimes providing an empty classroom in which to take tests.
- It is helpful to plan how to break-up large projects into smaller steps, so that they do not feel overwhelming. Prioritizing assignments can be helpful when facing multiple tasks.
- In school, students can benefit from being given more time to complete their tests or in-school work. However, I believe it is unreasonable to expect a student with ADHD to spend much more time than the average student in completing their homework. Thus, for many students it is important that the quantity of their expected homework be decreased.
- When listening to a lecture or talk, students with ADHD should be encouraged to take notes regarding the ideas they are being taught (rather than word-for-word transcription of what has been said.) In this way, they become active learners, and are more apt to maintain attention.
4. A Healthy Lifestyle
Promotion of a healthy lifestyle including sufficient sleep, well-balanced diet, regular exercise, and social support, is beneficial for everyone.
In particular, for people with ADHD:
- Adequate sleep (9-11 hours/day for children, 8-10 for adolescents, 7-9 for adults), is essential in many ways. People with ADHD should recognize that their symptoms worsen when they are tired. Furthermore, fatigue can cause poor mood, such as increased anxiety, which can exacerbate difficulties with focusing.
- Providing a well-balanced, regular diet can be very helpful in dealing with ADHD. Foods that may be helpful for people with ADHD include fruits and vegetables, protein-rich foods (especially at breakfast), and healthy fats from fish and nuts. Sugary foods should be avoided because they may increase impulsivity and inattention. Dehydration because of insufficient fluid intake can also worsen ADHD symptoms.
- Exercise (aerobic exercise for at least 150 minutes/week, and strength training at least twice weekly) can help reduce hyperactivity and improve concentration including through improving sleep.
- Their social circle should consist of supportive, non-judgmental individuals. Participation in support groups for ADHD can help people feel more at ease with their symptoms, and to learn new coping strategies.
5. Advocate
Some people with ADHD benefit from use of assistive technology such as apps that help them remain organized, or use of fidget toys to help them better focus. In these cases, the affected individual or their advocate should help push to allow uses of such devices at school or work.
Finally, it is important to recognize that even though a person with ADHD may be doing sufficiently well at school does not mean that they are not struggling to maintain their level of achievement. Thus, accommodations should be offered in these circumstances as well.
Takeaway
Optimal care for an individual with ADHD involves employing environmental measures such as described in this blog as well as treatment for the condition.
