In the article “ADHD Catastrophizing in Times of Crisis: What To Do When Fear Spirals,” author Tamara Rosier describes that when you experience fear taking over, it is important to take a second to regroup and calm your ADHD brain in order to release the anxiety and problem solve appropriately. Managing ADHD during a pandemic may increase feelings of confusion, frustration, and anxiety and this may make it difficult to adjust to new situations, such as distance learning or working from home.

Below, Rosier states some strategies for managing this illness.

• Conduct a Daily Check Up: This means evaluating a situation. Not only looking at a situation from a different perspective, but taking a second to check in with yourself and your emotions and anxiety level. Based on these levels, regroup and figure out what can be cut out, minimized from, or added to your daily routine.

• Reorient yourself: Individuals may have irrational thoughts focus on the worst possible situation and thereby spending less time regrouping or problem solving. By combining the daily, reality checks of your reality and taking deep, slow breaths, you are allowing yourself to regroup. 

• Recalibrate yourself: Do a brain dump and get rid of all your thoughts and worries that are making you anxious by writing them down on a piece of paper. Visually seeing what is causing you stress allows you to realize what is or isn’t manageable and realistic to possibly keep or get rid of. Rosier suggests asking these three questions to check in with yourself:

  • How am I feeling right now?

  • How is that feeling affecting my day?

  • Do I want to change how I am feeling right now?

• Keep a Daily Schedule: By scheduling a routine, you can prevent the tendency to leave plans open-ended and instead, improve your productivity. Rosier suggests following the usual routine with sleeping, eating, and exercising regularly like you would on weekdays, prior to the COVID-19 pandemic. You can do this by asking yourself what needs to get done in the day and doing it during your designated productivity time. 

• Set a Rhythm for the Day: Create and follow the usual routine that works for your brain and the tasks that you need to complete. For example, when you know you are not a morning person, wait for your medications to kick in before you seriously start working. While waiting, you can prepare yourself for the day by following the strategies listed above.

• Avoid Unhealthy Hyper focus: It is important to block out the things that make you lose track of time, whether this is social media, worries, or people. This could be setting a few boundaries to limit one’s self of spending too much time on a task.

• Stay Social: It is crucial to stay connected with the outside world and with others in order to build that emotional bond. Find time and ways each day to have a conversation with someone. Connecting and talking with others increases your mental health and thereby your ability to manage your day.

Although it can be difficult at first to accommodate these new strategies, practice does make better. In times of crisis as this COVID-19 pandemic, it is important to make connections, have conversations, and seek guidance. For more information on how we can help manage your ADHD symptoms and create routines that work for you, please contact us or visit Hilber Psychological Services. 

• Written by Lily Schmitt and Tanya L. Hilber, PsyD

References

Rosier, Tamara. “ADHD Catastrophizing in Times of Crisis: What To Do When Fear Spirals.” ADDitude. 24, April 2020. https://www.additudemag.com/adhd-catastrophizing-coronavirus-fear/

When navigating Coronavirus as a Family, author Dara Winely, found that her discussions with her clients shifted from “talking about what brought them into therapy to how do I talk to my children about the coronavirus?” As we all have experienced, this global epidemic has brought fear and anxiety to many. In specific, to seniors, as they are the ones most at risk. While daycares and schools are closing down temporarily, families are having trouble occupying their young ones without always resorting to screen time.

Studies have discovered “that children in families with high cohesion are likely to demonstrate low anxiety symptoms compared to children in families with low cohesion (Peleg-Popko & Dar, 2001; Victor, et al., 2007).” Below, Winely suggests this weekly calendar of entertaining activities to do with the family:

Mazed Monday. 

• Work on a puzzle or make one

• Create a scavenger hunt around the house

• Create your own escape room. 

1. Agree on a theme

2. Have everybody come up with 3-5 clues

3. Place them around the house

4. Make a list of rules

5. Set a time limit

6. PLAY!

Tuesday Tunes. 

• Create a playlist together

  • Each person is responsible for adding 3-5 songs

• Have a karaoke night 

• Listen to music all-day

Wind Down Wednesday. During these times, it is okay to feel anxious and concerned about the future. It is best to just take a step back sometimes and look at what is right in front of you: your loved ones. 

• Start the day off with a morning exercise or stretch

• Meditate or sit in silence 

• Listen to soothing nature sounds, ocean waves, or piano music

Thriving Thursday. 

• Help your kids stay on task by creating a brief “to-do list” 

  • This may include chores, homework assignments, reading time, and playtime. 

  • It also helps to set some guidelines as to when these tasks should be done and what the consequences or rewards maybe if done so or not to ensure goals are met. 

  • Don’t forget to include breaks

Fancy Friday. 

• Have your child pick a fun, family activity

  • Picnics in the backyard

  • Backyard tent camping

  • Late night dance party

  • Dinner and a movie

  • Play a board game

  • Cook for the next day’s meals or dessert

Sit Down Saturday. 

• Take time to answer any questions your child may have

• Ask them if you can help them with the transition from in school to at-home learning

• Openly process new information with them

• Have family meetings to listen to everyone’s needs

• Check-in with your child

  • What is on your mind? 

  • What do you care about? 

  • What are your values? 

Soul Sunday. 

• Take time to reflect on this past week

  • Winley recommends to take 15 minutes to do so by asking yourself these few questions and sharing them as you wish:

1. What was your favorite part of your day/week?

2. What has been the most challenging?

3. What do you hope to change this week? 

• Journal

• Take some “me time”

• Write letters to loved ones, checking in on how they are doing

By taking this time to spend with the family and by reaching out to others, it may help you feel less isolated. You may even discover something new about yourself or others. For more information on how to manage family weeks with COVID-19, please visit our website at Hilber Psychological Services or Contact Us for more information.

• Written by Lily Schmitt and Tanya L. Hilber, PsyD

References

Fuhs, M. W., Nesbitt, K. T., & Jackson, H. (2018). Chronic absenteeism and preschool children's executive functioning skills development. Journal of Education for Students Placed at Risk (JESPAR), 23(1-2), 39-52.

Peleg-Popko, O., & Dar, R. (2001). Marital quality, family patterns, and children's fears and social anxiety. Contemporary Family Therapy, 23(4), 465-487.

Victor, A. M., Bernat, D. H., Bernstein, G. A., & Layne, A. E. (2007). Effects of parent and family characteristics on treatment outcome of anxious children. Journal of anxiety disorders, 21(6), 835-848.

Winely, Dana. “Navigating Coronavirus as a Family.” Psychology Today. 17, March 2020. https://www.psychologytoday.com/us/blog/take-care-black-women/202003/navigating-coronavirus-family

Author Wes Crenshaw illustrates that poor sleep and attention deficit disorder (ADHD or ADD) are actually related. In detail, Crenshaw notes that “Poor sleep can lead to ADHD-like symptoms and complicate a diagnosis.” In fact, researchers, in the “ADHD Is a Myth” crowd, found that individuals with ADHD are declared to have sleep apnea, narcolepsy, or primary insomnia. It is then suggested that parents should start monitoring their child’s sleep patterns; ”quality of sleep must be considered in making an ADHD diagnosis” (Crenshaw). 

In crenshaw’s experience of working with two dozen teens and young adults for sleep studies, he found that the best solution to poor sleep patterns resulting from ADHD is stimulant medication. Results show that “Some teens will sleep better after beginning stimulants [and] A few will have daytime sleepiness despite taking them” (Crenshaw). Be aware that by treating ADHD with stimulants, sleep patterns will improve for some people while remaining or possibly limiting the effectiveness of the treatment for others, especially those with ADHD-related insomnia. Crenshaw notes that ”we find the Daytrana patch helpful for those with stimulant-induced insomnia, because it’s the only medication that can be shut off early (by removing the patch).” 

For those who have not had sleep problems before and have not overused napping but start to lose sleep after starting a medication, it is recommended that either they stop using stimulants and/or switch to a non-stimulant for ADHD. However, Crenshaw declares that “if the stimulants are working, we prefer to tinker with their timing and release to improve sleep.” This is why it’s important “to assess sleep problems before any medication is prescribed” (Crenshaw).

When trying to help teens develop a consistent sleep-cycle, it is import to remember that the results will not be apparent right away. Children, especially teens and those with ADHD, will first resist having restrictions on when they can sleep. For example, when trying ”to help a client manage stimulants and sleep, [scientists learned] that the client is staying up late and, in extreme cases, reversing the sleep-wake cycle” (Crenshaw). This is why good sleep is critical in treating one‘s poor habits and crucial to understanding the ADHD-sleep conundrum (Crenshaw). Because, if they do start to have a regular cycle, their quality of sleep will improve. 

In efforts to try to help teens with ADHD sleep better, try to 

1. Make time for it. Eight hours are recommended, especially with an hour of prep time. 

2. Turn off screens. They wake up our brains even more with all of the games and light they produce. 

3. Say goodnight to the (artificial) sun. It is important to shut off/block out (using shades) all artificial light in the evening. The body will then signal the brain that the night cycle is coming and that it should start preparing for sleep. 

4. Rise with the light. Progressively increase the brightness of a light in one’s bedroom (by using a timer) like the rise of the sun. 

5. No napping. Although ”many teens compensate for poor sleep by taking naps” (Crenshaw), researchers discovered that naps actually cause unhealthy sleep. In actuality, a 10- to 15-minute nap in mid-afternoon is recommended instead; “These may improve functioning and improve sleep” (Crenshaw).

For more information on therapists at Hilber Psychological Services can help your children and your family with parenting, sleep hygiene, and ADHD symptoms, please visit our website or contact us. 

For more information on how Neurofeedback services can assist your child with ADHD and sleep issues without the use of medications, please contact San Diego Center for Neurofeedback.

- Written by Lily Schmitt and Tanya L. Hilber, PsyD.

Reference

Crenshaw, Wes. “What Comes First: ADHD or Sleep Problems?” ADDitude. 18, June 2019. https://www.additudemag.com/adhd-sleep-problems-solutions/

In the article “What Is Executive Function? 7 Deficits Tied to ADHD,” author Russell Barkley discusses that an executive function “is the cognitive process that organizes thoughts and activities, prioritizes tasks, manages time efficiently, and makes decisions.” This is essentially the project manager for your brain.

Executive function skills are skills that motivate us to keep moving forward whether that is with a project or daily activities. Barkley states that ”Individuals with executive dysfunction often struggle to analyze, plan, organize, schedule, and complete tasks at all…” These executive functions are executed by the prefrontal cortex of the brain. 

Barkley notes that there are four circuits in the ADHD Brain and Executive functions:

• The “What” Circuit: Goes from the frontal lobe — linked to working memory and helps guide us on daily activities 

• The “When” Circuit: Goes from the prefrontal area to the cerebellum — it is the timing circuit of the brain —it determines the sequence in which we do tasks — explains why people with ADHD often have difficulties with time management.

• The “Why” Circuit: Goes from the frontal lobe to the central part of the brain to the amygdala — linked to our emotions —  helps us make final decisions based on how we feel. 

• The “Who” Circuit: Goes from the frontal lobe to the very back of the hemisphere —  where self-awareness originates from. 

By understanding these four circuits and relating them to those who have ADHD, you can see what types of symptoms an individual may or may not have with certain deficits with emotion regulation, time management and memory deficits. 

Executive functions helps people reach goals and future plans. Furthermore, ”it’s about how we behave toward our future goals and what mental abilities we need to accomplish them” (Barkley).

Executive function is determined by the strength of these seven skills and how they affect/change one’s behavior and self regulation:

1. Self-awareness

2. Inhibition

3. Non-Verbal Working Memory

4. Verbal Working Memory

5. Emotional Self-Regulation

6. Self-motivation

7. Planning and Problem Solving

These seven executive functions develop over time generally in chronological order. People who exhibit classic ADHD symptoms may have trouble with these seven executive functions. For example, those with ADHD who have problems with inhibition may have impulsive behaviors.

With awareness of these executive functions, parents can look for a professional evaluation to determine if their child has ADHD early on before it is apparent in their learning or grades at school. Then, those with ADHD can use knowledge, tools, techniques, and other treatments to improve their executive functions over time. 

For more information on how Hilber Psychological Services can help you or your child/teen with ADHD and executive functions, please visit our website or contact us for more questions.

- Written by Lily Schmitt and Tanya L. Hilber, PsyD

Reference
Barkley, Russell and ADHD Editorial Board. “What Is Executive Function? 7 Deficits Tied to ADHD.”  ADDitude. 3 Oct. 2019. https://www.additudemag.com/7-executive-function-deficits-linked-to-adhd/