A recent online report from ADDitude is raising the alarm about a mental health crisis for adults with ADHD.
According to their survey, 82% of adults with ADHD are in the grip of some form of trauma, at a rate much higher than the general population. These are figures gathered from U.S. statistics, Canada is long overdue for more research on this topic.
More than 50% of those surveyed placed the blame on the negative consequences of the global pandemic which in itself caused widespread loss of life, work, and social connections. Readers also indicated their mental health is worse than ever, with 74% reporting feeling overwhelmed and exhausted and more than half experiencing depression.
In the early months of 2020, physical distancing and sheltering in place were part of a strategy to keep people safe, but as time wore on, people with ADHD were especially prone to feelings of irritability, withdrawal, and apathy.
Add in the myriad ways that social media contributes to feelings of insufficiency, misinformation, and shattered attention, and it’s no wonder anxiety and stress are on the rise.
Trauma is an intense and lasting emotional response to an event over which you had no control. It can come in the form of a physical injury such as a car accident, a loss of a job you loved, bullying, or an ongoing situation that causes serious moral injury. In addition, the intense feelings can interrupt concentration and day-to-day functioning. Often physical feelings of pain, headaches, and nausea that come with trauma that can be debilitating.
Many of the symptoms of trauma and ADHD overlap and they include:
· Difficulty concentrating
· Racing thoughts
· Poor memory
· Emotional dysregulation
· Interrupted sleep and insomnia
· Impulsivity and/or restlessness
· Social withdrawal
· Substance abuse
People with ADHD often have dysregulated nervous systems that have evolved as a coping strategy so in addition to treatments that include stimulant and non-stimulant medication, finding ways to connect with your body can be a powerful method to restore some calm and safety.
Here are some measures you can take to support your mental health.
Body based or somatic therapies
Although somatic therapy is often used in treatment for people with PTSD, many people with ADHD benefit from learning how to check in with their bodies, often after years of feeling numbed out or shut down.
Somatic therapy guides you in how to feel safe in your body so that you are more present to your emotions and day to day stressors.
It’s often referred to as a road map, gently supporting you in understanding how emotions feel in your body so that you can be more aware and respond mindfully to triggers rather than feeling overwhelmed, reactive, or shut down. It also helps to distinguish between distressing external stimuli and a distraction.
It can help you build a sense of agency. For many people with ADHD, life can feel chaotic, uncertain and out of control. But tuning in with your bodily sensations can help you feel more in charge of your life.
Seek out community
It can be difficult for folks with ADHD to find a community that feels natural and safe.
One way to find like-minded people is to check out the event listings on Eventbrite or a community group listing on Facebook. With restrictions easing in Canada, many events are now being held in person with safety protocols in place. If you’re not yet comfortable meeting new people in person, there are many active mental health and social activity groups still meeting online.
It doesn’t necessarily need to be a support or mental health group to have real benefits for your confidence and sense of belonging. If you have a hobby you’re passionate about, search for groups in your area. There’s everything from kite enthusiasts to knitting groups, to pottery classes. Trying something new can bring immense rewards and help build your self-esteem.
Find a qualified therapist
Working with a therapist that understands the complexities of ADHD and has a trauma-informed approach can provide strong support and help you identify your strengths and explore and heal areas that are most troublesome.
We offer a list of therapists that specialize in adult ADHD.
It’s no secret that good therapy is expensive in Canada. But there are some ways to reduce the cost, either with a clinic that offers sliding scale options, or through a provincial benefit program that helps offset the cost.
For more information on how to choose a therapist read our post with insights from a practicing therapist.
Reduce online triggers
This is much easier said than done and there have been countless articles written about the negative impacts of too much social media or news consumption.
But for people with ADHD, it can be deeply distressing and cause lasting negative impacts on your mood and well-being.
Many smartphones now offer an option to limit social media to certain hours of the day, you can also turn off the news feeds in your settings and or consider using an app such as Freedom, to block the sites and apps that aren’t serving your overall wellness.
While there is no magic bullet to help you cope with trauma, there are incremental changes you can make that will bring some relief. You are not alone and there is help available.
If you are in crisis, don’t delay and seek help today.
Here is a list of agencies that offer real time support:
Hope for Wellness Help Line for Indigenous Peoples
(Canada-wide, provides culturally appropriate support and referrals)
Call 1-855-242-3310 (toll-free)
Canadian Mental Health Association (CMHA)
Crisis Centre BC
Immediate support for individuals in BC
When Suzette popped open her laptop at a café to catch up on some work, she planned to be working happily with the sounds of laughter, steaming milk and pressed coffee in the background.
Unfortunately for her, the vibrant noise of a local coffee house completely disrupted her ability to focus and she spent most of her time people watching instead of working.
“I see all these images on social media of people shredding their to-do lists while sipping an espresso in a funky coffee house and I’m so envious,” she says. “I want so much to be motivated by the energy, but instead I’m scattered and anxious.”
Suzette was diagnosed with ADHD in her mid-thirties after struggling to get her projects done on time as an office manager for a real estate company. Since her work was remote, she thought it would break up her days to walk to a local café to update spreadsheets. Instead, she lost hours of valuable time and was at risk of losing her job.
She did some research and discovered that people with ADHD are acutely impacted by different sounds.
A raucous anthem from their favourite band can help with cleaning up the kitchen, but the same high energy music would feel like nails on a chalkboard while trying to answer an important email.
People with ADHD are known to have heightened sensitivity to the physical environment. Sounds may feel like they’re happening in an intense rush and it can be overwhelming.
That’s why It’s extra important to curate your working environment.
For Suzette, working at her local library while streaming music through her headphones has helped her get control of her tasks.
“There’s a library a few blocks from me so I just set up at a quiet table in the morning and get my work done on time. It’s not the most exciting place, but I feel much more in control of my productivity.”
When neurodivergent people are in hyperfocus, it can be breathtakingly productive. A flurry of emails are written, bills get paid, and household chores get finished in record time.
Sounds can play a major role in setting you up for success. Read on for suggestions on how to make sounds and music work in your favour.
Curate your tunes
Brown noise has been rising in popularity on social media. It’s a specific frequency that’s meant to focus a busy ADHD mind. Studies have shown that it could work due to something called optimal arousal theory, which has been indicated to help neurodiverse people reach a more interested state. This could come in handy when updating code on a website, or organizing your desktop.
More traditional forms of music such as classical and jazz can help with focus so adding Vivaldi, Miles Davis or Mozart to your playlist can help.
Binaural beats, which are best enjoyed with headphones, play sound at a certain frequency with one ear and a sound at a different but similar frequency with your other ear. This coaxes your brain to produce a sound with the frequency of the difference between the two tones and it has been known to increase dopamine levels.
Many people report music with lyrics to be too distracting, so choosing an ambient playlist to keep you on track is a great idea. If your using a streaming service, commercials can be very disruptive so choose a service that gives you constant streaming without interruptions.
Seek out quiet spaces
Popular culture is filled with images of people typing away in busy environments, but the reality of ADHD’ers who may also be grappling with sensory processing challenges, it can be the worst place to complete work that requires linear thought.
If silence is too much, some people find running a fan or other appliance can help.
In a pinch, noise cancelling headphones can help blot out disruptive noise if you find yourself having to get work done in an open office or busy airport.
Remember, there is no one size fits all when it comes to managing noise distractions and what may have worked in the past may need rethinking depending on your work, school, and family priorities.
For more information on how ADHD impacts day-to-day life, read our blog about sensory overwhelm.
Choosing an ADHD Therapist
If you’re an adult with ADHD, creating a fulsome approach to your overall wellbeing can set you up for success. Medications may be a powerful tool to help you manage day to day tasks and responsibilities, while finding the right coach can help with motivation and accountability. The right form of exercise can also play a big part in managing symptoms.
There is another facet of holistic care that can make an enormous difference: counselling and therapy.
But googling “therapists near me” can yield a confusing array of service providers that may not have the training and experience to work with adult ADHD’ers.
For neurodivergent folks with specific challenges and possible co-existing conditions, a well-intentioned but under trained therapist could create more confusion.
We spoke with a counsellor that works with ADHD clients and asked for their insights.
If you are in crisis, help is available at the BC Crisis Centre.
In Vancouver, hart caplan is co-director of Nightingale Counselling. In addition to years of academic training and research, he has lived experience of ADHD after recently being diagnosed himself. He says it’s important for people with ADHD to drop the “should” around their challenges and let go of comparisons with normative behaviors.
“This is one of the things that I see my ADHD clients struggling with pretty regularly, which is: I should be able to keep a lid on my emotions,” he explains how difficult this can be for ADHD clients.
“I should be able to, even though I know I have this thing called auditory sensitivity or auditory processing disorder, I should be able to go into a busy restaurant. When you use the should now you're in a tension with yourself, because you've taken a kind of a normative understanding of what people should be able to do, and you can't do it.”
He says the pressure of trying to conform can be depleting.
“You then have to cast around and figure out why you can't do it. But that's kind of needless work, right? The reason that you can’t do it is because, you know, your neurology exists in a certain way that makes those things really super tough for you.”
He practices existential therapy which is described in his bio as a being towards authenticity rather than a curative or prescriptive approach. For clients with ADHD, it can be a relief to experience themselves as unique rather than flawed.
“My guess is people who are neurodiverse, who don't respond to classical, psychodynamic, or CBT, or these sorts of things, because they're not ultimately psychological problems but neurological problems. They're the ways that we are in the world. And some of that stuff is amenable to therapy. And lots of it isn't.”
“What I often say to people when they first come and we talk about ADHD, I say the two least interesting things with ADHD are attention and hyperactivity. It's not to say that they're not important, but to me, they're these downstream effects. They're just behaviors, right? You look at a kid or an adult who's hyperactive right and that's the end of the line, right? Like there's a whole causal chain of things that happen”
With so many therapy options, taking some time to ask for a consultation, trusting your gut, and reflecting on what goals you have for working with a counsellor are important.
Working with a counsellor can also be expensive. Depending on where you live, there may be some coverage through your provincial health plan or you may be eligible for a tax credit to offset the cost.
Whenever Scott thinks about going to the dentist, he feels anxious.
“The sound of the drills, the bright lights, laying on my back in front of strangers. It’s like a horror movie,” he says. “I know this isn’t rational, but there’s really nothing worse.”
Diagnosed with ADHD in his late 20’s, Scott is learning that his visceral fear of the dentist is an aspect of being neurodiverse.
It took a recent painful experience to motivate him to seek help managing his reactions.
His hands tremble as he tells the story of his recent dental experience. He says it started with creeping pain on the lower left side of his mouth.
He says it felt like a simple cavity at first. Leery about going to the dentist, he gargled with some salt water, took some Tylenol, and started searching for home dental remedies online.
He hoped it would pass. But three days went by and he woke up in the middle of the night, drenched in sweat and pain so sharp it brought tears to his eyes.
“It was the worst pain I’ve ever known! I actually thought my jaw was going to fall off.”
Dental infections are no joke and can lead to serious health complications. For folks living with ADHD, the combination of anxiety about being in the dental chair and procrastination can be a worrisome mix.
Scott is lucky to have dental insurance and find a dentist near his home to book an emergency appointment.
One of his molars was infected and he had to make the difficult decision of having it removed. Had he visited the dentist sooner, it may have been salvageable. He was also prescribed antibiotics to clear the infection that had taken hold in his mouth.
“I feel like such an idiot,” he says. “I should have gone to the dentist so much sooner, but like I said, it’s such an awful experience.”
Part of what makes Scott so sensitive about the dentist is sensory overload. It’s when one or more of the senses become overstimulated and the brain has difficulty processing.
Too much, all at once
There are several ways that the physical senses of ADHD folks can be triggered. They include touch, texture, smell, sight, sound, taste.
Visiting the dentist has all of them! It’s no wonder Scott struggles.
Touch: imagine how when the dentist has to pry open your mouth to examine your teeth. It can feel invasive and scary. Touch that is too firm can also lead to sensory overload.
Texture: the gritty paste the dentist uses to hold fillings in place can feel agitating. The strong stream of water that is used to rinse out the mouth can feel too cold, alien and alarming.
Smell: most ADHD’ers have a heightened sense of smell. The medication used by dentists and even our own breath — especially if there is an infection present — can feel horrible and lead to feelings of shame.
Sight: the bright lights at the dentist can be jarring for anyone, but for ADHD’ers it can be extra intense.
Sound: the piercing sound of the dentist drill can cause even more distress than the procedure itself. Auditory stimulants are one of the most intense causes of sensory overload for neurodiverse people.
Taste: the various gels and pastes that are part of getting dental work often have a harsh taste and this can trigger nausea and even more anxiety.
Ways to cope
Going to the dentist isn’t pleasant for most people, but there are some ways to minimize the discomfort of sensory overload.
1: A weighted blanket can help you feel calm and secure while the dentist works. If you don’t have one, you can request they leave the x-ray blanket on for the duration of the procedure.
2: Noise cancelling headphones: blotting out the sound of the drills can reduce anxiety and help you feel more in control.
3: Discuss your challenges with the dentist before they get started so they know how you are feeling. They may be able to reduce the brightness of the lights or use different tools.
4: Medication can help reduce anxiety and should always be discussed with your doctor to ensure it doesn’t interact with your ADHD medications if you take them.
5: Request a freezing agent without Norepinephrine. It’s a common agent used to help freezing last longer, but can have serious side effects, including increased anxiety.
The stress of going to the dentist can feel like too much sometimes, but developing some coping tools can go a long way in making the experience less overwhelming.
Early intervention is key for dental problems. Not everyone has extended health benefits and it can be costly. Many dentistry schools, including UBC offer reduced price dental services provided by recent graduates. In BC, there are several community dental clinics that also offer reduced price dental services.
Rebecca remembers it like it was yesterday. She recalls being in a meeting with colleagues going over the yearly marketing plan, when she lost control of her emotions. Her peers were suggesting some changes in tactics and she felt like a complete failure. Tears welling in her eyes, she says she abruptly removed herself from the meeting.
“I’m still ashamed when I think about that day,” she says.” Whenever I feel my chin start to wobble at the first sign of feedback from my boss, it’s like I’m a toddler and not the professional I need to be.”
Now in her 40’s, she is starting to reflect on her challenges in group settings and questioning her self-perception as emotionally damaged and lacking in character.
After a recent ADHD assessment, Rebecca is starting to understand that her responses to situations are an aspect of undiagnosed ADHD, not a personal failing.
The intensity is real
For Rebecca and millions of others living with ADHD, it’s difficult to regulate emotion, leading to frustration, impatience, and outbursts.
In an effort to meet new people, she recently joined an online dating site. She says if she doesn’t get a response or a conversation goes cold (which is common in online dating), Rebecca sees it as a flaw on her part and spends two days in bed, scrolling social media and eating junk food.
This is partly due to the diminished working memory of folks with ADHD. When someone like Rebecca isn’t able to access other thoughts or memories, her thoughts may become hyper fixated on a negative memory or experience and before she can adapt, her emotions hijack her attention and flood her brain with one intense and unwanted emotion such as anger or sadness.
Now that she is beginning to understand herself more through a treatment plan that includes therapy and coaching, Rebecca is implementing a toolkit to help her navigate intense emotions.
She uses a meditation app and listens to soothing music when she feels agitated by the news of the day. For Rebecca, social media can be especially challenging. Seeing highly curated photos of her peers and celebrities causes intense feelings of inadequacy.
Awareness is powerful
With her newfound awareness of how her emotions can easily become overwhelming, she limits her time using an app that pauses her social media accounts during working hours. She says it helps.
“I used to feel so awful while scrolling social media but now I take intentional breaks and I’ve unfollowed hashtags that are distressing or make me feel insignificant.”
Rebecca is also working with a therapist to help her navigate work dynamics and the related stress. She’s already noticing a difference in how her colleagues respond to her in meetings and in correspondence.
“By taking more time to respond in highly charged situations, I’m able to organize my thoughts better and offer solutions to thorny problems instead of reacting from a place of fear or anger.”
Regulating emotions for people living with ADHD can seem like an impossible feat, but there are ways to help reduce the intensity.
Tips for managing intense emotions
Get it on paper. Often, seeing your thoughts on the page diminishes their power. If you don’t have a journal handy, using the voice notes on your smartphone can also help.
Breathe from your belly in through the nose counting to 4 then out through the mouth, counting to 4. Repeat 4 times.
Mindfulness, while popular in the general population can be stressful for ADHD folks, so start with mini-meditations of 1-5 minutes.
Resist the urge to binge on unhealthy foods and eat plenty of vegetables and fresh fruit.
When feelings become intense, stop and drink a glass of water.
Reach out to your community and don’t self-isolate
Count to five or even 10 before speaking. It will give your mind the chance to slow down and provide a calmer response.
If your emotions feel out of control, seek help immediately through a crisis line, listed below.
BC Crisis Line (includes links to other services)
Crisis Services Canada
Robbie McDonald was diagnosed with ADHD in mid-life and writes about mental health from her home in the beautiful Pacific Northwest.