In 1989, a New York Times food editor got so tired of the mountain of requests she received every September for her plum torte recipe (which the paper had run seven years in a row), that she began her September column with this warning: “This is the last time we are publishing this recipe. I suggest you make several copies and laminate them, because you will not be seeing it in this newspaper again.”
Reader, get ready to laminate. Not because what follows is revolutionary, or very hard to find, or even original, but because it’s the most important piece of ADHD management advice you are ever going to read.
If you’re reading this magazine, odds are good that either you have ADHD, or you live and/or work with someone else’s ADHD. Early on in your ADHD travels, you heard about or read the solid statistics showing that the most successful ADHD management comes from the use of both properly prescribed medication and behavioral training.
You are probably looking for another new strategy, one more idea, some fresh thinking about or unique approach to the management of this quirky brain. You may already have read many of the thousands of articles about ADHD management and medication on the Internet, read your Attention magazine from cover to cover every month, and even attended workshops and classes on ADHD management. You should be doing these things, because when you live with ADHD, the more you—and your loved ones and colleagues—know about it the better.
But, you are wasting your time if you think that any of these inventive approaches and new theories will work unless—before the meds and before any behavioral training—the three critically important foundational elements of ADHD management are in place.
So, what are these fundamentals? Sleeping, eating, and exercising— or SEE. Don’t start laminating yet.
I know what you’re thinking right now: “Seriously? Thank you, Captain Obvious.” And under normal circumstances, your indignation would be warranted. Who doesn’t benefit from sleep, food, and exercise?
But hold on. We’re not talking “normal circumstances” here. We’re talking Way Far Away from Normal here—we’re talking ADHD. We’re talking about the fact that ADHD is a neurobiological condition, and the fact that ADHD brains are demonstrably, measurably different from non-ADHD brains, in ways modern neuroscience is finally allowing us to see and analyze for the first time ever. How are they different?
- ADHD brains grow more slowly (usually three to five years more slowly) than non-ADHD brains. So until around the mid-twenties, when these brains “catch up” in size, the cognitive abilities of a person with ADHD are compromised, often seriously. Think about the computer you used three to four years ago and the one you’re using now—talk about performance differences!
- ADHD brains produce lower levels of neurotransmitters— such as norepinephrine, seratonin, and dopamine—than non- ADHD brains do. Neurotransmitters are the signal carriers in our brain that translate thoughts (intentions) into action. Insufficient signal carriers cause the ADHD brain’s signaling system to be even less efficient than Lily Tomlin’s switchboard. Electrical signals that drive vital brain functions such as memory, task execution, time awareness, prioritizing, organizing, etc., are often fuzzy, crossed up, or missing in an ADHD brain. Think of Western Union trying to cover telegram deliveries for all of New York City with six guys on bicycles. That’s a lot of undelivered messages. (The good news: in about eighty percent of ADHD diagnoses, properly prescribed and managed medication can substantially improve the neurotransmitter imbalance.)
- ADHD brains process glucose (brain fuel) at a slower rate than non-ADHD brains. So? This produces slower processing speeds, less RAM, and more mixed signals.
Now factor this in. A brain that is physiologically unusual will naturally produce behaviors that are also unusual, and unfortunately, often problematic, such as:
- impulsive, interruptive blurting out of inappropriate comments
- a disinclination to make or follow any work plan
- the habit of starting one project after another and leaving most unfinished
- the chronic inability to be on time, or to judge correctly the amount of time required for a task, or to keep to a schedule
- an inability to stop working on a project when good judgment or circumstances say it’s time to stop
- a disinclination to perform any administrative tasks—even urgently required ones—because they “feel boring”
- frequent forgetting, regardless of importance
- a lack of awareness of the impact of all of the above.
So what’s so important about those three fundamentals, regular sleep, eating, and exercise? Read and learn.
ADHD brains are (or can be) like wild animals. Unconcerned with the conventional limits of time, or rules, or oughts and shoulds, this brain is happiest going where it wants to go, when it wants to go, and staying there as long as it wants to stay! For all its amazing positive attributes— resilience, inventiveness, generosity, big-heartedness, originality, a great sense of humour, spontaneity, and kindness, to name just a few—it can also be, well, a brat. An ADHD brain really likes having its own way, and it has no qualms about hijacking your schedule or putting you in the doghouse yet again while it spins through space entertaining itself.
Imagine trying to control a powerful, unbridled horse that’s galloping full-tilt towards a cliff… or having to drop everything you’re working on to charge after a much-loved but unruly and untrained dog that’s racing out of sight. Remember the tiger in Life of Pi? How it took all the wits and skills and stamina Pi had to keep that tiger from eating him? Like that tiger—extremely dangerous, but manageable with skills and determination.
An ADHD brain can take you on an unbidden mental chase in a nanosecond, undoing all your best intentions and leaving a pile of unfinished business, missed appointments, hurt feelings, and deep regret (among other things).
If you have ADHD, you need to be in your best possible shape every day to manage this powerful, free-spirited brain, because if you don’t manage an ADHD brain, it will manage you.
For people who don’t have ADHD, eating, exercise, and sleep are almost discretionary in terms of impact on their effectiveness and output. But for people who have ADHD, proper eating, exercise, and sleep are mandatory. They provide the energy, strength, clarity, and staying power that’s needed hour by hour, day by day, every day, to stay in charge. As Dr. Ned Hallowell likes to say, having ADHD is like having a fabulously powerful Ferrari brain with just one problem: It has bicycle brakes.
You simply cannot develop the tools you need to keep this brain under control all day, every day if you’re tired, or your blood sugar is low, or you’re out of shape and running on empty.
So before you use one more new calendar, download a snappy new app, buy five more clocks, or adjust your meds, make sure these three fundamentals are in place every single day:
- SLEEP enough. Every night. Whatever it takes. On a regular schedule if possible. No all-nighters. (Okay, maybe one a year when you’re on a roll, if you must; ADHD brains love all-nighters.)
- EAT enough. Make sensible choices, at regular intervals. No skipping, even though some meds may make skipping easy. Don’t do it. Do not skip meals. Periodic healthy snacks which provide both protein and fruit sugar will keep you alert and productive all day. And always have water nearby; hydrate throughout the day.
- EXERCISE enough. At a reasonable, not a killer level. At least three times a week, though daily is best. Thirty minutes is fine. Use it to kick-off a work block, or to take a break from one. Just do it.
Okay, now laminate. You only need the last three points. Post them where you can see them every day, and pay attention to them—if, instead of being run around by your ADHD brain, you want to be the one who’s in charge.
Katherine McGavern coaches adults with ADHD and is a certified Parent to Parent teacher. She presents talks on ADHD to teachers (K-12), community organizations, and parent groups; provides training on ADHD to student teachers at The College of New Jersey; and is a member of the editorial advisory board of Attention. McGavern is a co-founding member of CHADD Mercer County, and facilitates at their monthly meetings in Princeton, New Jersey.