Edge Foundation Blog

by Kelsey Peterson, guest blogger.  (To read more of Kelsey’s take on life with ADHD, check out her other posts in  Stories from the Edge.)

I have always been an active person; my family vacations were planned around hiking and outdoor sports. I love to move and be outside but when I started college things changed. I no longer had golf practice after school in the fall or tennis practice in the spring. I went to design school where the closest thing to a school football team was an annual fashion runway show off between our competitor school and us.

College was much more time intensive and stressful than I was prepared for. So I started working with an ADHD coach to help me stay on track of my school assignments. I had to start prioritizing my time between studying, sleep and exercise. After my first semester my grades were great but my body was not – I was sleep deprived and overweight. The sleeping, eating and exercise habits I had formed were unsustainable and I realized I had to change them if I were going to survive four years of college.

I talked to my coach about putting together a new plan for organizing my time. We came up a plan that allowed for me to study, get enough sleep and workout 3 to 4 days a week. Simply by making a detailed plan I learned that I did have time for everything.

My studying, sleep and exercise plans evolved with each semester catering to my new classes. I saw my grades improve as my health did. The more I took care of myself the more awake I was during the boring lectures and the better I could focus on what I was reading.

During my junior year I tried Bikram yoga per my doctors suggestion after I had some shoulder problems. Bikram yoga is the hot yoga you’ve probably heard about, a 90-minute class in a room that’s kept at 105 degrees 40 percent humidity. My first class was awful; I felt nauseous, light headed and HOT! I went back again to try to give it another chance because of the supposed health benefits. I started to enjoy the quiet slow moving activity. Because of the poses and the heat it required me to have absolute focus. I started to challenge myself slowly to improving my flexibility and endurance. When I was stressed about school I would go to yoga and forget about it, I would leave feeling calm and more motivated.

I have kept up with my yoga practice up ever since. I find that I function better if I allow myself that 90-minutes of meditation. When I feel very anxious about something or depressed I give myself the gift of going to yoga and letting those toxic emotions go. Because of the intense heat the session bring out whatever is going on with you and the challenge is to let it go and focus on your meditation.

Whatever exercise works for you, it’s important to find one or two or three that you enjoy! If I do the same thing every day I get bored. So I try to switch it up, I’ll do yoga 2 or 3 times a week, and other cardio things the other days. I love to go on run/walks with my best friend in Central Park.  She lives on the west side and I live on the east so we meet in the middle and do a loop around the reservoir. Living in New York City another one of my favorite things to do is walk everywhere. If I have enough time I’ll walk instead of taking the subway. I always try to do different routes to get common destinations making my walks interesting every time. Another fun social way to get exercise into your routine is taking classes. I love ballroom dancing classes; ballroom is a workout that also challenges your mind. It takes coordination and memorization and has proven benefits for brain function.

When it comes to exercise keep these tips in mind:

• Set up a game plan with your coach to make exercise a priority in your life.
• Try a bunch of different exercises and pick the ones that work best for you, whether that be weight training, yoga, walking, etc.
• Switch it up! Don’t get stuck in a rut with your workout, have fun with exploring new things.
• Making exercising a social event. Instead of going to happy hour or to a movie suggest going on a scenic walk or kickboxing class with your friends.
• Make your commutes into exercise by walking. Make sure to switch up the routines to see new things and keep you interested.

When you have ADHD it is especially important to have exercise be part of your life. Remember that exercise boots brain function and releases endorphins, which give you the feeling of well-being.

What exercises have you found to be the best for you? How have you seen your performance at work or school change in relation to you activity level?  Please share your experience in the comments.  Or join the discussion on Facebook.

Related posts:

Reducing ADHD Symptoms with Exercise

Treating ADHD with Exercise

This month we are pleased to interview Carolyn Dukarm, M.D. Dr. Dukarm  is founder and director of the Center for Eating Disorders, which is an outpatient treatment center that specializes in the overlap between disordered eating symptoms and attention problems.

Edge: It’s surprising to find out that people with  ADHD are prone to obesity.  Why do you think that’s true?

Dr. Dukarm: Both ADHD and eating disorders tend to cause individuals to be disconnected from their internal cues.  Those with ADD are easily distracted and may miss a meal; then, they feel ravenous and are at risk for binge eating.  Hunger and satiety cues are often misinterpreted.   Restricting eating when hungry, and binge eating beyond fullness, temporarily destroy the communication between the stomach and the brain. Scheduling meals can help with this, but for people with ADHD the task of scheduling meals  can be challenging.

Edge:  Can you speak to the reasons for how impulsive eating by girls and women with ADHD turns into an eating disorder?

Dr. Dukarm: Several key characteristics of ADHD can contribute to the development of an eating disorder. Individuals with ADHD exhibit impulsivity (which can result in impulsive binge eating), distractibility (and, therefore, a tendency to often be distracted by thoughts of food and body image), and poor attention and organizational skills (leading to difficulty following a meal plan.) Impulsivity can cause binge eating, poor food choices, use of food as a reward, out of control eating and self-medication with food (specifically carbohydrates.) Distractibility can lead to binge eating because of difficulty following a meal plan, trouble estimating portion size, a persistent internal “running conversation” regarding food and weight and stimulation-seeking behavior through food. In addition, poor attention and concentration can decrease awareness of internal cues including hunger/ satiety and contribute to unstructured eating.

Edge: What do you mean when you say some people self-medicating ADHD symptoms with food?

Dr. Dukarm: Sugar and high glycemic carbohydrates can temporarily increase the neurotransmitter, serotonin, and therefore can create a temporary feeling of calmness or a decrease in anxiety. However, due to the effects of low-glycemic carbohydrates on blood sugar, these feelings are only temporary and soon result in a paradoxical reaction of increased restlessness and irritability when blood sugar levels decrease.  In addition, this paradoxical reaction can cause an increased craving for sugar, contributing to the cyclic pattern of binge eating.

Edge:  What are some healthy eating habits that may be obvious to everyone else that ADHD women and girls have to learn the hard way?

Dr. Dukarm: Meal planning does not come naturally to most people, especially those with ADHD and some people with eating disorders.  However, without some amount of pre-planning meals for the day, the risk of binge eating increases.  Therefore, temporarily eating in a more “mechanical” fashion (by your watch, not your stomach) while becoming more in tune to internal cues can re-establish this feedback loop and break the starvation/binge eating cycle.

Having the right foods, in the right place, at the right time decreases impulsive eating.  Structuring eating is essential for people with ADHD and eating disorders, providing a framework for feeling safe at meals.  Structuring and planning meals actually decreases the amount of time spent thinking about food.  It is important to be realistic and make sure your meal plan can actually be carried out given your schedule on a specific day.

The following suggestions may help to develop a beneficial plan:

• Eat every 3 to 4 hours. Eating every three to four hours stabilizes blood sugar and prevents hypoglycemia (low blood sugar).  Hypoglycemia is a common trigger to binge eating, because low blood sugar can result in a paradoxical reaction of carbohydrate craving.  In addition, eating small, frequent “mini-meals” throughout the day stimulates your metabolism and digestion.
• Set specific times to eat. Pre-determining times to eat, i.e. every four hours, can actually decrease the potential of feeling overly hungry and thereby reduce the risk of binge eating.
• Set specific amounts to eat. Pre-determining how much to eat and when to eat it can prevent the pattern of hoarding food until late in the day, a common trigger for binge eating.  Pre-determining portions often serves as a way to maintain a sufficient intake until hunger and satiety cues are reestablished.
• Enhance the quality of your nutritional intake. Balancing adequate quantity of protein, carbohydrates and fat at every meal and snack will significantly affect appetite, cravings, binge eating, mood and attention.  In addition, choosing high quality proteins, low-glycemic carbohydrates and quality fats will lead to further improvement in appetite and attention.

Edge:  Can you point us in the direction of any research studies or books on this topic for parents or professionals to learn more about this important issue?

Dr. Dukarm: In my book Pieces of a Puzzle: The Link between Eating Disorders and ADD, I include sections for individuals, as well as specific information for professionals who treat eating disorders or ADHD.  Several peer-reviewed journals, including the Journal of Women’s Health and the Journal of Abnormal Psychology have published articles on the overlap of these disorders.

Do you ever hold back about sharing that you have ADHD?  You aren’t alone.  Some people’s parents tell them not to disclose it for fear their child will be discriminated against.  Some people hold back because they are ashamed of the impact ADHD has on their lives.  Still others can’t face another conversation explaining how ADHD is a real condition – not symptom of bad parenting, media hype or poor diet.  It can feel risky to reveal you have ADHD.

Sharing that you have ADHD with your friends, families and teachers is a very private and personal decision.  With ADHD Awareness Week just around the corner (September 13 – 17, 2010), we’d like to offer a few thoughts about the positive side of disclosing your ADHD and using it as an opportunity to educate others.

1. Secrecy breeds shame: Keeping a secret that is never discussed has a dark side – it can leave you feeling like there is something wrong with you that you have to hide.
2. Secrecy build barriers: When you decide to hold back about your ADHD, you build a little wall between you and that person.  The longer the wall is in place, the harder it will be to disclose the truth.  While the other person is oblivious, you can end up spending a lot of energy worrying about being discovered.
3. Secrecy keeps YOU in the dark: You can’t educate yourself about ADHD very easily if you aren’t open about having it.  Asking questions of an expert, sharing experiences with other people who have ADHD and learning strategies to work with your strengths and weakness – all require that you are open about having ADHD.
4. Secrecy can hurt you: If the people around you don’t understand that you have ADHD, they don’t have the same kind of compassion for your mistakes as they might otherwise have if you’d give them the opportunity.  Moreover, you need to be able to disclose your ADHD status if you want to receive accommodations in school.

Being Open About ADHD

We hope we’ve shown you some of the positive side of  “coming out” with your ADHD with your family and friends.  If you do, may we recommend you don’t just blurt it out there?  But that you take a three step, thoughtful approach to disclosing your ADHD status:

1. Take the time to do it right. Tell people when you have time to talk about it and they can ask you questions.  There are a lot of misperceptions about ADHD out there and people often don’t have any idea what it means to have ADHD.
2. Educate yourself. Be ready with information about what ADHD is and how it affects people. ADHD affects everyone differently and so understanding your own symptoms and need for support will empower you to advocate for yourself much more effectively. There are tons of resources on the web.  A particularly good one that addresses common concerns people may raise was written by ADHD Coach, Pete Quily http://www.addcoach4u.com/doesaddreallyexist.html.
3. Ask for help. When you talk about your ADHD, don’t be afraid to ask people to help you out.  That can mean being understanding when you slip up by being late, interrupting or running in three different directions.  Married couples should definitely spend time working out the give and take of an ADHD relationship in managing home life.

Finally, if you do share, be sure to pat yourself on the back.  By being open, educating others and asking for help, you pave the way for other people with ADHD to share and learn – or even discover for the first time that they aren’t stupid, lazy or inconsiderate – they just have ADHD!

Do you disclose your ADHD or keep it to yourself?  Have you ever had a bad experience in sharing?  Tell us your story in the comments.

By Robert Tudisco, Edge Foundation Executive Director

I wish I knew back in college what I know now about living with ADHD.  I had to learn ways to cope the hard way because I wasn’t diagnosed until many years after I completed school.  Since my diagnosis I’ve developed many skills that have made a huge difference in my life.  Here are four survival skills I’ve discovered that any college student with ADHD can use to make college more productive and stress free.

READING COMPREHENSION

Many of my prelaw classes had heavy reading requirements that pushed my ADHD brain to its limit.  I tried everything I could think of to stay focused, but my mind always wandered and I struggled with comprehension and staying on task.

Then in senior year, a friend of mine who worked in an accounting firm mentioned that her firm routinely handed out foam earplugs for reading tax code.  The text was very boring and she said that it helped her stay focused.  I immediately went to the store and bought some.

When I inserted the earplugs into my ears, it was like shutting off the world so I could actually climb into what I was reading.  The effect was amazing.  Those small inexpensive foam earplugs got me through the rest of college, law school and the bar exam.

After law school, an office setting presented a new challenge:  I couldn’t just shut it off.  Phones were ringing, people asked questions and my earplugs were of little use.  I experimented with sound machines and music to filter out distractions.  After much trial and error, I determined that classical and guitar music struck the balance that I was looking for.

The important thing to note is that I didn’t give up.  I thought about my focus challenge.  I tried – failed – and tried again.  My thought process and commitment made all the difference.

OUTLINING

Another useful tool I use that also helps with procrastination is outlining.  If, like me, you’ve tried and given up on lists because they are long and intimidating, give outlining a try.  Outlines help me understand how each task is connected and provides me with a map for getting there.  I outline everything that I do, from articles to case briefs to scheduling my day.

• An outline provides the structure my ADHD craves for whatever project or time frame that I need to plan.
• An outline provides a hierarchy of concepts and shows how they are related to each other.
• An outline breaks down projects to smaller subprojects and thereby makes them less intimidating.  Often the hardest part of task is getting started.  Breaking the project into the smallest components makes this much easier.

EXERCISE

After my diagnosis with ADHD, I went back and looked at my school transcripts and tried to correlate the times that I got the best grades with what was going on outside of school.  I quickly saw a pattern.  During the times when my grades were highest in college and law school, I was running to relieve my stress.

After this realization I embraced running and made it a part of my life.  I regularly run 4 to 5 days per week for approximately an hour.  My running helps me organize my thoughts and plan out how I am going to approach situations.

In recent years, research has shown that exercise can help reduce the symptoms of ADHD, anxiety, depression and other disorders.  Integrate exercise into your daily life.  If you keep at it, you’ll find it centers you, reduces your stress and brings you the clarity you need to move forward.

COACHING

One of the most important things that I have discovered in my journey to work with my ADHD is I need help to establish the structure, support and accountability that my ADHD mind so desperately needs.  That’s why I have worked with many different ADHD coaches since my diagnosis.

ADHD coaches offer an objective perspective on the challenges of ADHD.  They help us recognize and develop our talents, and learn where and why we struggle.  Each of my coaches has made a huge difference in how I approach obstacles while building my confidence about the specific talents that I have.

College is a key time to learn skills to work with your ADHD because it is much less structured than high school – especially for those students living away from home for the first time.  You may not have even realized all of the daily support your parents were providing until you are in over your head freshman year.  Even students who are extremely intelligent are at high risk because college requires new levels of self imposed structure and accountability.

An ADHD coach who specializes in the needs of high school and college students can provide the structure, support and accountability you need, not just to survive in college, but to reach your full potential throughout your life.

YOU CAN OVERCOME THE OBSTACLES OF ADHD

As someone with ADHD who has struggled all of his life with the challenges it has provided, I am living proof that there are ways to successfully address these obstacles.  The key is to understand yourself, be willing to try new things, reflect about how you respond to situations and don’t be afraid to ask for help.

Keep that perspective and you will learn to gravitate toward your strengths and to avoid your weaknesses.  And always remember you are not alone.  There are a lot of us out there just like you.  Good luck!

Dear Edge,

I see you have another training class for coaches running.  Why shouldn’t I just sign up for that instead of hiring a coach for my son?

Sincerely,  Sandy L.

Dear Sandy,

We’ve heard that some parents believe that they should sign up for ADHD coach training instead of hiring an ADHD coach because it’s so much less expensive.  We of course disagree.

Yes, understanding how coaching works can be helpful to you, but it doesn’t replace the value of getting coaching in real life for your student.  Why?

• High school and college students do not want to hear anything from their parents about anything – it’s their job to break away and be independent
• The student, not the parent, sets the ADHD coaching agenda – it can be difficult to detach from your personal agenda as a parent and critical for your student to be empowered to direct her own life path.
• Just because you’ve taken the class doesn’t mean you have the experience our coaches bring to the table.  Sure you know your child, but we know dozens – and that gives us perspective on many different approaches that work, or don’t work, for different people.
• Edge coaches have received previous life coaching training and have at least two years of experience.  ADHD coaching is an advanced coaching skill that takes practice.  That’s why our coaches receive mentoring after they complete the class.  They also have access to the expertise and wisdom of the Edge coaching bench – when they find a problem they haven’t encountered for, they can bounce ideas and strategies off the team for input.

If you want to learn more about the coaching process, Edge Foundation coach trainer, Jodi Sleeper-Triplet has a great book at the printers on the topic that you can preorder here:   Empowering Youth with ADHD: Your Guide to Coaching Adolescents and Young Adults for Coaches, Parents, and Professionals

What’s your opinion, do you think the outside perspective of a coach can accomplish more than a parent’s influence?  Sound off in the comments, or join the conversation on Facebook.