Sunday, February 14, 2016

Book report: Your Life Can Be Better: Using Strategies for Adult ADD/ADHD

I have been reading Your Life Can Be Better: Using Strategies for Adult ADD/ADHD by Douglas Puryear.  Like the other ADHD books I've read, it's very readable.  It's written for people with ADHD, so it's easy to pay attention.  Mostly, the book consists of Puryear describing the strategies he uses to live with ADHD.  It also tells about how some of his friends and clients deal with ADHD.  I like the way it has a light, humorous tone.  He describes a coping strategy, but then adds that he's still working on, he doesn't get it right all the time, "after all, I have ADD."  He says that so often that it becomes humorous.

Previously I read a book about ADHD in women, but this book is more about men.  Not only is he male, so are many of the other people he writes about.  He has little to say about coping with cooking and other household chores.  He has a wife who takes care of that stuff. 

How he copes with ADHD:
  1. Identify a problem
  2. Choose a strategy
  3. Make a rule
  4. Follow the rule so much it becomes a habit.
Example: Always leave your keys on the table.

His red flags are "it will be okay," and "I have plenty of time."  When he tells himself, "It will be okay to put the keys somewhere else just this one time," then he applies the rule "put your keys on the table."

Make it a habit to check every time.  Put your fishing gear in the car the night before.  In the morning, check to see if it's all there.  You know you put it there last night, but check anyway.  You are making it a habit.  Do it every time.  No exceptions.

You can only work on establishing one or two rules/habits at a time.

He says that things that activate focus for people with ADHD are
  1. Personal interest
  2. Novelty
  3. Challenge
  4. Immediate deadline with heavy consequences
For me, I think there is something else, but I'm not sure how  to name it.  Stories suck me in.  Facebook sucks me in.  I gravitate toward these things that suck me in.  I gravitate to being engaged.  I gravitate toward things that make me forget that I'm tired, that I'm bored, that I'm aimless, that my life is screwed up.

He carries an appointment book with him and looks at it at least six times a day.  It includes a weekly schedule and a monthly schedule.  Looking at it helps keep him oriented in time.  He has made it a habit to write everything in it carefully and legibly.

He also keeps his index cards with him all the time and looks at them often.  One red index card lists the five most important things to do.  No more than five, because if there are more than five, he would feel overwhelmed and not do anything.  Yellow for things to do that aren't urgent.  Orange for things that are kind of urgent but not the top five.  He numbers things on the red card in the order he plans to do them.  When he finishes something on the red card, he can move something from the orange to the red.

Blue is for memory.  It includes phone numbers, names, sayings, etc.  Purple cards are for ideas for the book.  White cards are for everything else, such as things he is studying, like Spanish conjugations and guitar chords.  

In addition to the five things on his red card, he has his list of three.  This he keeps mentally.  It includes what he is doing now, what he will do next, and what he will do after that.  That keeps him on track, keeps him from getting sidetracked.

A similar technique, which he does not use, but which works for some with ADHD, it to begin the day by visualizing what you are going to do that day.  

He breaks things into steps.  He doesn't write "do taxes" on his red card.  The first task is "organize taxes" which means make a list of all the steps to doing his taxes.  Then each step will be an item that eventually makes it to his red card.  But he won't have all five tasks on his red card be about taxes.  He mixes it up, the five tasks go to different things. 

In his office, he is surrounded by lists.  He makes lists on envelopes from the mail he gets.  There are four stacks.  One is the blank envelopes.  One is his working lists.  One is his other lists, things like ideas for the book he is writing, Spanish conjugations, guitar chords.  The fourth is things he refers to sometimes.  He rewrites his lists many times a day.

In addition to lists and index cards, he has two white boards in his office for jotting down things he wants to remember.

Make lots of lists.  Put everything on a list.  If it's not on a list, you hold it in your head and you feel overwhelmed.  Keep your lists organized.  Look at them often.

Don't let things pile up.  If they pile up, they become overwhelming.  If they do get piled up, break the tasks into manageable steps.

Set realistic goals.  Don't aspire too high.  Make it something that you will actually accomplish, or you will become demoralized and overwhelmed.

Don't take on too much.  Learn to say no.  Say no to your own aspirations, and to what others ask of you.

You could ruminate on decisions for a long time.  Reduce the amount of decision making needed by setting rules.  For example, he has a rule that if his grandson asks him to play with him, he will always say yes.  He wishes he had realized that in time to do the same for his kids.

Every now and then, stop in the middle of what you are doing and ask yourself, "Is this a good use of my time?"

Notice the little things in your daily life that you get tangled up over.  Once you identify a problem, you can come up with a solution.

Identify your long-term goals.  Look at whether your short-term goals and your current activities support your long-term goals.

He wrote:
I will be in the middle of a productive project, like writing this book, and then it pops into my mind that I'd like to know about the six wives of King Henry the VIII.  I'm already at the computer, so I just look that up on the internet.  That's easy; there they are.  That leads to the interesting puzzle of figuring out who the various Marys were, and that leads to looking up the dates of Queen Elizabeth's reign....Then the idea for a good short story about Elizabeth comes into my mind, and I begin to write it before it escaples me, but I have to do some more research to get the facts right.
 That's how I work too.  In fact, in typing the above, I of course had to go look up Henry VIII's wives.

The way he deals with this is to periodically ask, "Why am I doing this?"  "Is this how I want to be spending my time right now?"  "Is there something I'm avoiding?"

When you get distracted, just label it.  Say, "That's a distraction.  I don't have to follow it."

We  need to take breaks from work, but we can get sucked into the breaks.  It did not really work for him to set time limits or alarms.  That does not work for me either.  Instead, mindfulness is more helpful to him.

When he finds himself thinking, "I'll do that later," that's a signal to consider whether to do it now.  If it's something quick, it may be quicker to do it than to put it on the to do list.

Another red flag is, "I have plenty of time."  That's a signal to remember that if he stays focus he has enough time to do what he needs to do, but if he does something else, he won't have enough time.

It's helpful to choose one thing to focus on.  He is learning to play guitar, and he has online lessons, lessons on a DVD, and books.  What he needs to do is make a list of all these approaches to learning to play guitar, and then pick just one of them to focus on.

That's how I am with reading nonfiction.  I have more than a dozen partially read nonfiction books.  If I could stick with one, I could finish it.  And the same with projects.  I think I want to volunteer at the food pantry.  Then I want to get a job in institutional research.  Then I want to learn to play harp.  Then I want to get a job as a registrar.  Then I want to move to another town.  Then I want to stay here and get more involved in the community. 

Don't think of all the things on your list.  Pick one thing to do first?  What do you have to do? A lot.  No.  Right now you just have to do one thing.

One of his slogans is "Do it now, do it right, do the hard part first."

Regarding do it right, his instinct is to cut corners, and I have that too.  People with ADHD, including me, often have a tendency to walk away from a tasks when it's almost done, rather than when it's done.  Regarding doing it right, he says there's a saying, "If you don't have time to do it right the first time, when will you have time to do it over?"

Another slogan he uses is "Fearless."  When he is trying to decide what to do, he says that to remind himself not to let fear hold him back.

Don't say "I have to" or "I should."  Say "I need to" or "It would be good if I."  When looking at the past, instead of saying, "I should have," say, "Next time I will."

Make games and challenges for yourself.  Reframe your tasks.  If you are raking leaves, pretend you are in a leaf raking competition.  Or rake leaves with headphones on and see it as an opportunity to listen to music.  If you get home from work wanting to relax and find your wife wants you to deal with the problems of the four kids, pretend that you need extra money so you took a second job at a residential treatment facility.

Feeling overwhelmed is a state of mind, not a  reflection of reality.  When you feel overwhelmed, it's time to get organized.  Make lists.  Break things into steps.  Decide what is the one thing you need to focus on now.  Focus on that and forget the rest.

When we feel stressed, we tend to skip the things that ease stress.  We skip sleep, prayer, etc.  Don't do that.

In the chapter on studying and learning, he says, "just because you bought a book doesn't mean you know the material in it," and "I tend to scatter myself out and go in many different directions at once.  And thus I often don't get anywhere at all."  So, when he want to learn something, he focuses on one thing, and keeps on it, he strives to "overlearn it.'

Sometimes you get stuck.  The task before you is too big so you don't start it.  But that's the thing you should be working on, so you don't start any other task either.  When this happens, choose the smallest, easiest thing to do, and break it into small steps until you find something small enough to do.  Can't clean the kitchen? Maybe you can wash the dishes.  Can't wash dishes?  Maybe you can was one fork.  Can't wash one fork? Maybe you can get out the dishwashing soap.  Once you do one thing, give yourself positive self-talk for doing.  Continue the cycle -- do another small thing, and give yourself positive self-talk.

Sometimes your brain freezes due to anxiety.  Get out of it by taking a break.

Take breaks to address short attention span.  You'll get more work done in a two hour block if you take a 10  minute break in the middle than if you try to work straight through.

Sometimes we get irritable.  If this happens, step back.  Observe that you are irritable.  Take a breath, say a prayer, wonder how it looks from the other person's side.

He mentions parenthetically when talking about his friend Tom, "when we find something that helps us, we quit doing it."  I do find I don't stick with things.  Though it's not necessarily things that help me.  If I'm on a medication or  taking a supplement, I like to stop and start just to check it is having in impact.  But when I've done that and seen that it has an impact, I do stick with it.  I once mentioned to someone that when I'm feeling healthy, I experiment with quitting some of my supplements.  She seemed to think that was foolish.  But I have actually found that some of my supplements were not actually helping me.  And they can cost a lot of money.

Use memory aids, such as mnemonics and anchors.   An anchor is when you connect something you want to remember with something that is a part of your routine.  He has exercises that can be done while driving.  Whenever he gets on a certain street, that's his cue to do the exercises.  When he stirs his coffee, he thinks of  Jesus.  When he goes to the bathroom, he says the prayer of St. Francis.

He carries a card with him with principles he wants to remember, and reviews the card regularly, like when he's waiting in line.  Principles are things like, "What are you avoiding?" "Is this the best use of my time?" and "Focus on one thing/overlearn."

Sometimes we establish good habits, like looking at the card with the principles, and then we stop doing it.  We forget.

We don't do things.  We forget.  We procrastinate.  We avoid.  But then when we do things, we over do them.

He writes, "When we do something, we don't do it half way -- well, that isn't true.  We often do it half way, because we know it isn't going to turn out anyway and because we have trouble finishing.  So we do a lot of things half way.  What I  meant to say is that we don't get into things half way.  When we get into them, and our focus center is turned on, we really get into them." 

That resonates with me.  He goes on to talk about buying lots of stuff for a new hobby, and then dropping the hobby.  That's true for me.  Not always all the buying, but getting interested in something, and imagining how I'm going to practice every day and get really good at it, and then not practicing.

In most of the book, he describes strategies for living with ADHD.  Near the end he says, "most of these strategies involve some willpower," and "willpower is something we have in short supply."

Some study tips he suggests are
  • Start by reading "kindergarten" book on the topic, like for Dummies, to get an overview of the topics.  When reading a chapter, skim it first and read the summary if there is one.  Before going to a lecture, skim some material on the topic of the lecture.
  • Try to outguess the teacher and figure out what questions will be on the test.
  • Imagine that it's a big deal, like the final test before you become an astronaut.
  • Overlearn the material.
  • After each page, close the book and write a few notes about what the page said.  Also do the same for bigger chunks, like a few pages or a chapter. If you can't do it, go back and review and try again.  When your mind is free, like when you are waiting in line, review in your head.
  • Learn the material from today, and re-learn the material from three days ago and the material from ten days ago.  If you don't review the old material, you will forget it.
I haven't followed a particular study method, but I do something similar.  I write things down, and I see whether I can call them up in my head.  I've made flash cards.

His advice for meditation: "The main thing with meditation is not to become too frustrated with it. You're probably  not going to be very good at it.  Just do what you can and you'll find it helpful."

In many areas, I do what I can and don't mind that I'm not good at it, such as tai chi and dance.  However, I mind when other people become impatient with me.  But I think I do get frustrated easily in the area of repair, like house stuff and car stuff.  That's different though.  I can dance and look like a klutz but I'm still dancing.  But if I try to change the windshield wipers but I can't get them off, then I haven't changed the windshield wipers.

So, the key points from the book that I want to follow are:
  1. Decide what you're going to do and stick to it every time.  Establish a habit.
  2. Mindfulness.  What am I doing? What do I want to be doing? What am I avoiding? That's a distraction. I don't have to follow it.
  3. Keeping a collection of lists -- the master list of everything, the short list of what to focus on now, and everything in between. 
  4. Keep a list of principles, and check it regularly.
  5. Sleep, exercise, and meditate.
  6. Break things into small steps. 
  7. Look for red flags, like "I'll do that later," and "I can make an exception this time."
And the above list will be my list of principles.  And another principle may be to periodically check my notes from reading ADHD books.  He says just because you've bought a book doesn't mean you know the material.  And for me, just because I've written notes about a book doesn't mean that notes are going to stay in my head.  

Saturday, February 13, 2016

ADHD meme

From the Facebook page ADHD - Tales of an Absent-Minded Superhero:

ADHD is not a learned behavior
ADHD is not a discipline problem
ADHD is not a spoiled child
ADHD is not a temper tantrum
ADHD is not a choice
ADHD is not the easy way out
ADHD is not a willpower issue
ADHD is not an inability to control oneself

ADHD is a medical condition
ADHD is a chemical imbalance
ADHD is a big deal to those who suffer with it
ADHD is a a fight to fit in
ADHD is a struggle to develop relationships
ADHD is a battle to maintain self confidence
ADHD is a deathmatch between brain and body
ADHD is a Real Thing

Please educate before you conversate

That's why I hate it when people tell others just to get it together.  It's not that easy.  When you tell people what to do, you're not helping them to do it. What you are doing is eroding their self confidence.