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
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.
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!
Early in 2020 when worldwide pandemic lockdowns forced most people inside, Sheila felt strangely excited. As a highly sensitive person with ADHD, she looked forward to being safely away from the office drama. Her employer’s open office concept was painfully distracting, but working from home she was certain she would be much more productive. She relished the idea of being at home with her young son. An added benefit: no more gruelling commutes!
Two years later, she’s not holding up so well.
“Some days I roll out of bed and just feel hopeless,” she said. “Between global news, the lifting of mask mandates, and my tight financial situation, I don’t know which way is up.”
Uncertainty Affects Wellness
Sheila is far from alone. Millions of people worldwide have been navigating chronic uncertainty for the better part of two years. Our brains aren’t designed for this level of heightened anxiety and stress.
Our limbic system is efficient in fight or flight response when we need to act quickly to outrun a predator or perform an urgent task, but when it feels like every day is an emergency, our entire nervous system can get overwhelmed by cortisol and adrenaline.
For people with ADHD, it’s even more disorienting as they experience more intense symptoms than the general population.
Learning to Cope
When time permits, Sheila takes her five-year-old for long walks around Trout Lake in East Vancouver. She finds the willow trees, paddling ducks, and quiet atmosphere brings her back to the present moment. Her son can cavort with other kids at the playground and skip rocks over the smooth surface of the lake.
“It’s the only time I get to just be and breathe,” she says. “Work is always busy, but trying to do it from home while my son needs my attention feels impossible some days. I’m lucky to work with a company that understands this and gives me some flexibility so I often work on my projects late into the night while he’s sleeping.”
Diagnosed with Inattentive ADHD by her family doctor at 30, Sheila manages her symptoms with psychostimulant medication but has started wondering if she is depressed. She’s far from alone: 85% of adults with ADHD meet the criteria for a comorbid condition with a high prevalence of depression and anxiety.
She has scheduled time with an online therapist to help her sort through the complex emotions she’s feeling and plans to discuss other treatment options with her doctor.
Strategies on Dealing With Uncertainty and ADHD
In the meantime, there are strategies and habits that can help Sheila, and anyone struggling with this long emergency to reduce the stress of chronic uncertainty.
1: Sheila is wise to get into nature. Studies show that even a short walk in an area with clean air and trees can reduce negative thoughts and release stress.
2: Connect with friends. Positive feedback loops help our brains build new neural pathways, which are vital for creating new memories.
3: Start a journal. While apps and notes on our smartphones can be efficient, the physical act of putting pen to paper can help calm our nervous system and slow down racing thoughts.
4: Invite more joy. Yes, the world is scary sometimes but finding moments to laugh throughout the day will help release pent up tension.
5: Reduce your news and social media consumption. ADHD brains are wired to seek out stimulation, but when it comes in the form of war and unattainable beauty standards, it can lead to tremendous suffering.
For further information on how to be assessed for Adult ADHD
More helpful suggestions for managing Adult ADHD
1 CADDRA - Canadian ADHD Resource Alliance: Canadian ADHD Practice Guidelines, 4.1 Edition, Toronto ON; CADDRA, 2020
Katzman, M. A., Bilkey, T. S., Chokka, P. R., Fallu, A., & Klassen, L. J. (2017). Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC Psychiatry, 17(1), 302. https://doi.org/10.1186/s12888-017-1463-3
3 Kathleen Fuegen and Kimberly H. Breitenbecher.Ecopsychology.Mar 2018.14-25.http://doi.org/10.1089/eco.2017.0036
Robbie McDonald was diagnosed with ADHD in mid-life and writes about mental health from her home in the beautiful Pacific Northwest.