Do you find yourself always late for appointments because you have not factored in the “true” time it takes to get ready and get there?
Do you miss deadlines, because you think you have plenty of time left to complete your work?
Do little microbreaks from your work tasks end up consuming your whole day?
Have you ever sat down to plan a budget or get ready for a big life event and felt as though it was impossible to conceive?
If some or all of these scenarios seem familiar, it’s likely due to time blindness.
First popularized by ADHD researcher Dr. Russell Barkley in a 1997 paper about self-regulation and time perception in people with ADHD, Dr. Barkley also called this phenomenon temporal myopia. Put another way, literal near-sightedness to time.
Some folks in the disability community are uncomfortable with the term, but as of this writing, there hasn’t been a widely accepted alternative.
It’s important to understand that time blindness is the result of perception so working with your strengths and calling in support when you need it can really help.
Many adults are able to conceive and plan three months into the future, but with ADHD’ers, it’s closer to a week or two, sometimes even less. The future can feel like an abstract fantasy, which leads to a lack of urgency.
Reduced time horizons make it difficult to plan for the future and set goals.
The good news is there are proven ways to address this.
Watch out for time sinks
Social media, with its potential for infinite scrolling can rob you of valuable attention and time throughout the day. Logging on to post a photo can lead to an array of rabbit holes and may even trigger feelings of inadequacies, the last thing neurodiverse people need!
Try blocking specific times of day to interact via social media. Many people report holding off until later in the day when work is done also helps lower the chance of being exposed to negative news. There are also blocking apps that will prevent you from accessing social media during certain times of the day.
Track your days
Add a day in your calendar to record how long it actually takes to do things. For example, when answering an email, set a timer and log the amount of time it takes into a document. Making lunch? Set a timer.
Record every activity, even leisure time. Don’t sweat it if some tasks take longer than others, this is simply a way for you to get realistic about how long things take during the day so you can approach your work and responsibilities with more ease and realistic expectations.
Speaking of alarms, set up reminders and alarms on your devices and have a wall mounted or digital clock within your field of vision. It’s a good idea to build in some transition times for screen breaks and exercise. Being pulled from one task to another without a sufficient break can be extra taxing for adults with ADHD, so work with your abilities, not against them.
Schedule planning time
When you put your goals and budgets into a planner or document, it gets easier to see how much time you have to meet your deadlines and responsibilities. Having dates on your wall calendar can help with visualizing where tasks are at and what still needs to be accomplished.
Chunk it down
ADHD’ers can get overwhelmed with multiple projects and assignments, that’s why it’s key to create small doable tasks and set a timer to track how long it will take to get work completed.
There is also a risk of being given too much time, without tools and a blueprint of action, it can feel like being sucked into quicksand.
Building in small wins throughout the day, which provide extra motivation will help keep you on track to your goals.
Bring in a coach
Working with a coach can help you get back on track when things feel out of control in your day-to-day responsibilities. Many coaches offer programs aimed specifically at supporting you in time management.
Time blindness can cause unwanted frustrations throughout the day and can impact your long-term health, career and personal goals, but by setting yourself up with supportive apps, careful planning, a coach, and setting alarms, you’ll be well on your way to managing it.
For more ADHD content and inspiration, check out our new TikTok @adultADHDCentre and YouTube channel!
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.
ADHD + Women: Part Two
This is the second article in a series about the unique challenges that neurodivergent women and gender diverse folks experience.
For adult women with ADHD, the different stages of life can be an unwelcome roller coaster of emotional upheaval and physical discomfort.
Estrogen plays a key role in the production of dopamine, which supports working memory, pleasure, and focus. When dopamine levels are high, alertness, focus, and happiness come easily.
For ADHD’ers that already struggle with low dopamine levels, changes in estrogen production throughout life can be deeply frustrating. In addition, once women reach their 40’s and 50’s, some of the symptoms of perimenopause and menopause mimic and overlap with ADHD, leading to even more confusion. Given that a large amount of the existing research focuses on the male experience of ADHD, it can be mystifying to understand what’s happening.
The good news is understanding how hormones interact and influence the brain throughout life can go a long way in helping you feel empowered to make healthy choices, wherever you are in your discovery journey.
Once in adulthood, women experience three distinct stages that have a dramatic impact on hormones, especially estrogen:
As previously posted on the Adult ADHD Centre blog women of reproductive age experience fluctuating hormones that can impact their ADHD symptoms.
For women during their reproductive years, the time of the month when estrogen levels drop just prior to the menstrual cycle, can be especially challenging. Low mood, anxiety, sleep disturbances, changes in appetite, difficulty focusing, can all take a toll on well-being. For those that have children, the post-partum time can feel even more depleting and disorienting.
Having children, work, and other responsibilities during this time can feel overwhelming. Neurodivergent people need support and self-compassion during these hectic years.
The literal translation of perimenopause is “around menopause”. It’s a natural transition that happens to most people with a uterus, but can feel alarming and scary, which is why it’s so important to have all the facts.
How does this impact ADHD symptoms for women? The dramatic changes in estrogen levels can wreak havoc on concentration and mood and depending on whether you take medication, can also make the usual dose less effective.
For most people, perimenopause starts in their 40’s, but some report symptoms as early as 35. Here’s what happens: the rate of estrogen production by the ovaries begins to decrease. Some women refer to this as estrogen’s storm season, with good reason. It’s unpredictable, sudden and can cause emotional upheaval. Some days, estrogen levels can be high, the next, very low. This can lead to insomnia, anxiety, and depression.
It’s important to consult a doctor or nurse practitioner during this time. Some women find relief with hormone replacement therapy, but it doesn’t work for everyone.
Women that have not had a menstrual period for 12 months are considered to be in menopause. During this time, the ovaries are no longer producing estrogen and menstruation stops. For those that have had a hysterectomy, this can happen much earlier in life.
For some, this can be a relief from the monthly stressors of menstruation, but for others, diminished libido, hot flashes, low mood and insomnia can cause tremendous distress. For ADHD women that already struggle with healthy sleep, it can feel completely overwhelming.
Finding what works for your life situation is absolutely crucial. Not everyone wants or needs hormone therapy. For gender diverse people, this time can be even more challenging, but there is help available.
Information is key
Given that women are often diagnosed later than boys and men, when hormones may have started fluctuating, this can be a difficult time. The grief that comes with an adult ADHD diagnosis can also contribute to feelings of inadequacy. If it’s available to you, work with a counsellor or coach to help sort through the complex emotions that arise with an ADHD discovery.
Informing yourself, asking questions, and talking with others on the ADHD discovery path can be empowering and minimize the confusion and stress of these natural phases of life.
Most importantly, be gentle with yourself as your body changes!
This is the first in a series of blogs about how women with ADHD navigate their unique challenges. She/her pronouns are used, but these concerns can impact those in gender transition and/or anyone with a uterus.
Andrea used to think she was losing it. For several days every month, she’d be unable to focus, sad, and more disorganized than usual.
“It was like I fell off a cliff. All the systems I had in place to keep me on track were pointless and I would cry if someone looked at me the wrong way on the street,” she says.
For years she wondered why she couldn’t muster the energy or focus to execute basic tasks at home and work around the same time each month.
Diagnosed with ADHD in her late 20’s, Andrea takes stimulant medication and has stabilized on a dose that overall works very well for her. When she noticed it wasn’t as effective as usual, she started to wonder why her male friends with ADHD didn’t have the same experience.
Concerned and curious, she spoke with her doctor.
The estrogen connection
Turns out estrogen plays a crucial role in the production of neurotransmitters in the brain, including dopamine, norepinephrine, and serotonin. They all play a role in cognitive function, so when they’re running low, it can have dramatic and unwanted impact.
When someone with a uterus experiences an average 28-day cycle, estrogen levels remain steady, but around the 14-day mark, called the luteal phase, progesterone production begins to minimize the beneficial effects of estrogen.
For women with ADHD this time of the month, emotional storm clouds gather and it may feel like stimulant medications aren’t working.
“Even with my medication, I would struggle to get to work on time and it felt like I had to make excuses for late deadlines,” says Andrea. “It was like walking through a soupy fog for two or three days.”
In addition to lowered focus, decreased estrogen can lead to anxiety, irritability, trouble sleeping, low libido, and even depression.
It’s no wonder Janice struggled!
Neurotransmitters and medication
Widely considered the standard treatment for ADHD, stimulant medications are either methylphenidate based or amphetamine based and they work by blocking re-uptake of dopamine and norepinephrine, leading to higher available levels in the space between nerve cells, known as the synapse. Note: not everyone benefits from this treatment, it’s important to speak with a professional familiar with stimulant therapy.
Some studies point to estrogen aiding in the effectiveness of stimulants, but more research is definitely needed.
The good news is there are ways to manage your well-being. Some women find relief through doctor-monitored hormone treatment, others find reducing caffeine and making dietary and exercise adjustments are helpful.
For Andrea, adjusting her birth control prescription and stimulant medication made a big difference. She feels more even-keeled throughout the month.
“I know folks often talk about medication feeling like putting on glasses for the first time, but that’s exactly what happened when I adjusted my birth control pill and stimulants. I feel amazing!”
She says even though this has helped her, she still has sad days from time to time. She also says it’s always wise to work with a medical professional.
Some other suggestions to help gain control of your focus and well-being:
1: Keep a diary of your menstrual cycle and highlight problem days
2: Focus on getting enough sleep
3: Reduce caffeine
4: Speak with your doctor about your ADHD medication, it may be time for an adjustment
5: Eat a well-balanced diet with plenty of fruit, vegetables and healthy proteins
Wherever you are on your ADHD discovery journey, it’s important to educate yourself and practice self-compassion.
Thanks for reading. The next article in the series will focus on women in perimenopause.
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.
Robbie McDonald was diagnosed with ADHD in mid-life and writes about mental health from her home in the beautiful Pacific Northwest.