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Email: ADHD@parhar.com

​Adult ADHD Centre
Unit 202
Burnaby Square
7885 6th Street
Burnaby BC
V3N 3N4

Fax: 604.525.8124
​
www.parhar.com

Notes from the ADHD Journey

​

Women and ADHD

6/15/2022

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​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!

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Neurotransmitters and medication
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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.
 
 
 


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Sensory Overwhelm

5/22/2022

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A 25 year old man wipes his brow in frustration.


 
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.

A dentist opens the mouth of a distressed patient
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​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.
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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.
 


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Emotional Regulation and ADHD

5/4/2022

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A Black woman is sitting on the floor with her hands in front of her face. Her expression is one of shame.
​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.


A woman writes in her journal while sitting on lush green grass.
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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 

 
 
 
 


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Choosing an ADHD Coach

4/26/2022

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A white woman with messy blonde hair is searching for ADHD coaches on her laptop.
​Chances are, if you’re on the ADHD discovery path, you’ve come across various ADHD coaching services through Google searches and following hashtags on social media.
 
Services you read about may range from group coaching, to online courses, to high priced one-on-one coaching sessions.
 
Since coaching isn’t a regulated service, unfortunately there are folks out there selling courses and online groups that haven’t been properly researched and are simply looking to make a profit.
 
Sadly, these programs can cause more harm than good and can be very expensive, sometimes adding up to thousands of dollars.
 
Caution is advised of course. But for the neurodiverse person, desperate for some strategies to help with organization and time management, they can be very tempting.
 
What’s a curious ADHD’er to do? Read on for some advice on how to choose wisely for your well-being and success.
 
Multi-pronged solutions
 
It’s vital to note that coaching is not therapy. Coaches help with any number of challenges, including time management, organizing your workspace, relationships, studying for school exams, professional development, career advancement and more.
 
It’s important to understand that coaching can be an incredible part of a well-rounded toolbox for managing ADHD. Medication can help with focus and impulse control, but cultivating sustainable habits takes more effort and practice.
 
In tandem with a medical professional such as your family doctor or nurse practitioner, a clinical therapist, and a well-rounded exercise habit, working with a coach can yield incredible results.
 
Do your research
 
A good coach will usually have some form of certification and some may offer references or testimonials.
 
Keith Gelhorn is the founder of ADDvocacy a certified ADHD coaching and training provider.
 
He says it’s wise to choose a coach with lived experience of ADHD.
 
Keith struggled with mental health challenges before being diagnosed with ADHD as an adult.
 
His deep understanding and compassion for the many challenges that ADHD brings are strong assets for a coach. He says implementing executive function strategies takes time, prolonged effort, and commitment to become habit.

He also advises being wary of astronomical claims from online coaching programs that promise quick fixes but don’t deliver. If group coaching makes sense for your schedule and/or budget, choose online courses that have a cohort/group coaching component with weekly or bi-weekly interaction from the coach.
 
While he is open about his own ADHD discovery, Keith is also a seasoned coach and can offer clients tangible exercises and tools to reinforce their commitment to improvement. It’s an effective strategy and he works with clients to meet their academic and career goals with a high success rate. 


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​Ask questions
 
Once you’ve found a coach that feels right, don’t be shy to ask for a discovery call. Most coaches offer a 15-30 minutes of free consultation so you can ask questions.
 
Here are a few sample questions to get started:

 
Have you taken accredited training directly focused on ADHD? 
How long have you been coaching? 
What brought you to ADHD coaching?
Do you have lived experience with ADHD or have a close relationship with someone who does?
What can I expect in a session? Do you use frameworks or guides?
How do you measure results?
Can you offer any references or testimonials from other clients?
How much will it cost? 
 
After a phone call, you should have a good sense of whether it’s a good fit.
 
Trust your gut
 
Always trust your instincts! ADHD’ers have often spent a lifetime not trusting themselves due to negative feedback from peers, family members, and colleagues. But your gut is usually right so if a coach feels too high pressure, or not firm enough, keep searching until you find the right fit.
 
Depending on your work situation, some coaching may be covered by extended health benefit programs. But if you’re freelance or a sole proprietor, it might not be covered. All the more reason to practice due diligence and research carefully before signing on with a coach or online program. 

Students may find some financial relief through federal education grants.
 
Remember, this is about you finding healthy ways to manage some of the challenges that come with ADHD. It’s your choice and your well-being. 

Whatever route you decide to take, researching and learning about how to best support your success will yield great results. ​

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Tax Tips: You've Got This!

4/18/2022

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It’s April 19th, how are those taxes coming along? If that sentence strikes terror in your heart, we’ve got you covered. Continue reading for some helpful suggestions on how to tackle doing your taxes without going off the rails.
 
A major struggle and source of anxiety for ADHD’ers is financial paperwork so it makes sense that neurodiverse folks feel extra anxious around tax time.
 
But this yearly personal administrative task can potentially yield some financial relief, depending on your situation. With living costs skyrocketing across the country, spending some time to organize your files and get ready to submit your taxes can yield big results.

ADHD tax 

People with ADHD pay what’s colloquially known as an ADHD tax for all the forgotten subscription sign ups, library late fees, and spoiled groceries. Not to mention the high cost of medications that often aren’t covered by Pharmacare or personal health insurance plans. 

If you're already paying more for so many other things, why not take some time to ensure you're getting the benefits you're entitled to? 
 
In Canada, the Disability Tax Credit or DTC is designed to help offset the many costs of living with a disability. If you’re not on disability, that’s ok, you can still apply. Many working Canadians with varying degrees of challenges qualify for this benefit. Take some time and read through the criteria.

Don't leave money on the table

It’s important to research what benefits you may be entitled to! Most tax credit programs aren’t widely advertised so we’ve created a resource page, just for you. 
 
In order to apply for the Disability Tax Credit, you’ll need to work with a nurse practitioner or your family doctor to fill out the form. Depending on your health care team and access, this should be free of charge, but check with your provider. In BC, the Medical Services Plan covers this fee. Even if it isn't covered, it can be applied as a deduction on your taxes next year. 
 
Once you apply for the credit, it usually takes two to four weeks (longer around tax time, due to high volume) to be screened and approved. Once you receive the letter of approval, you can fill out your taxes.

But wait, there's more! Once approved for the DTC, you can open up a Disability Retirement Savings Plan which is a fantastic way to set yourself up for future financial security. For those younger than 49-years-old, there are government grants that can help you grow your funds so make sure you ask about this important resource. 
 
Help is available

We understand just thinking about taxes and all that mundane paperwork is often the overwhelming part! But there are many free tax software programs available online if you have a fairly straightforward tax return.
 
There are also free tax clinics that many non-profit organizations, including MOSAIC, that help folks new to Canada navigate the complexities of the tax system. 
 
In Vancouver for example, many neighbourhood houses host tax clinics. For a full directory of local tax clinics, visit this page on Canada.ca.
 
If you are on disability, there are advocates that can assist with more complex tax returns through Disability Alliance BC.
 
For those with very simple tax returns, Wealthsimple Tax has a no-nonsense online filing system that links directly to your CRA account.
 
There are expenses that you can claim but may not be aware of, including the cost of some medications, even medical assessments such as those for ADHD. A helpful guide can be found here.
 
At the Adult ADHD Centre, we understand how hard it is to start a daunting task such as your taxes, but as with many other projects, getting started can break the spell of analysis paralysis and/or perfectionism.
 
Break it down
​

One way to minimize overwhelm is to break it down into smaller chunks. For example, taking 20 minutes to read up on free tax clinics, then take a 5-minute break, then return to signing up for a CRA online account if you don’t yet have one. Once you get rolling, you'll be surprised how quickly it all comes together. 
 
Remember, the urgency and stress you’re experiencing from procrastinating on your tax return may not be how the government sees it. In Canada, even if you overlook an important item on your return, you can refile through the CRA my account online portal.
 
Wherever you are on your journey, it’s important to give your attention to this yearly paperwork. You may even be entitled to a tax credit or refund!
 
 
 


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    Author

    Robbie McDonald was diagnosed with ADHD in mid-life and writes about mental health from her home in the beautiful Pacific Northwest. 

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