Edward Hallowell, MD, diagnosed himself with ADHD more than four decades ago. “I didn’t even realize it existed until then,” Hallowell, 76, founder of the Hallowell ADHD Centers in Boston, Massachusetts, and author of ADHD 2.0. “I was always a mishmash of contradictions: I was the world’s slowest reader and never organized or on time, but I also was able to graduate premed with honors from Harvard.”
Six percent of American adults live with ADHD. More than half aren’t diagnosed until adulthood. “Many of these people are very intelligent, creative folks who managed to mask their symptoms for years,” says Hallowell. “But when they are finally diagnosed, it’s literally their “aha” moment: Suddenly everything they’ve struggled with in their past makes sense.”
It helps to try to recast your ADHD in a more positive light, too. “I jokingly refer to ADHD as a superpower,” says Hallowell. “But people with ADHD often have qualities like an ability to hyperfocus, extreme creativity, and an ability to think outside the box. When it’s treated properly, it can be a strength. I tell patients that it’s like a gift that’s hard to unwrap, but when you get help unwrapping it, you see all the rewards.”
There can definitely be challenges when you live with ADHD. Research shows that adults who have this condition report less relationship and career satisfaction than people who don’t have it. They are also 60% more likely to be fired, and they have higher unemployment rates in general.
To thrive with ADHD, you need to find the right mix of medications, therapy, and coaching strategies. “It can be a bit of trial and error, but most adults are able to achieve success,” says Mariely Hernandez, PhD, a psychologist at Columbia University Irving Medical Center in New York City who also lives with ADHD.
It can be hard to know exactly what success looks like when you treat your ADHD. But there are a few things you’ll want to keep in mind.
Better Time Management
“It’s the biggest concern of all my patients with adult ADHD,” says Hernandez. “They can really struggle with how to prioritize tasks, and on how much time to spend on each one.”
Adults with ADHD may also struggle with something known as time blindness. “People with ADHD have a very fluid sense of time,” says Hernandez. “A minute may feel like an eternity.” This helps to explain why, for example, you always are late to events and meetings. “You underestimate the time you need to get ready,” explains Hernandez. “It’s not deliberate.”
There are some specific strategies Hernandez works on with her adult ADHD patients to help them improve with time management:
- Keep a calendar. “I make sure all my appointments and meetings, and even daily tasks, are in my calendar,” says Hernandez. “Otherwise, it’s easy to forget, or even to double book.” You can also set a reminder 30 to 60 minutes before, to help you prepare.
- Set alarms. People with ADHD often hyperfocus, which means they can easily spend hours on activities, notes Hernandez. An alarm helps to remind you it’s time to switch to another task.
- Use app blockers. This way, you are less likely to get distracted as you go through various emails or your social media feed.
Less Procrastination
When you have adult ADHD, it’s easy to put off work that needs to be done. “People with ADHD struggle with executive dysfunction, so when they are given a task, they don’t know how to start,” explains Hernandez. “This can lead to task paralysis, where you become so anxious and overwhelmed that your brain literally shuts down.”
Your ADHD therapist or coach can show you ways to boost your productivity and help you get started with big projects. Some strategies that may help you find success include:
- Break down big goals. “I have one mantra I give to all my adult patients, which is, ‘If you can’t get started, the first step is too big,’” says Hernandez. She works with clients on “chunking,” or the breakdown of large projects into smaller, more achievable goals. Set a deadline for each one to help you progress.
- Body doubling. It’s a strategy where you do tasks along with another person. “They help keep you focused and work with you to minimize distractions,” explains Hernandez. They can be right next to you or on a Facetime or Zoom call. “It’s what got me through graduate school.” Don’t have anyone? Go to a coffee shop or library. “Sometimes, just being around other people who are quietly working is motivating,” adds Hernandez.
- Pomodoro technique. This is a time management technique where you divide tasks into 15-minute to 25-minute blocks of focus, alternated with five-minute breaks. “The ADHD brain is more suited to sprints than marathons,” says Hernandez. “It responds really well to short, intense bouts of work, then take a brief pause to let your mind recalibrate.” It’s a technique Hernandez finds especially helpful herself as a working mom of two. “I don’t have eight-hour chunks of time to power through complex tasks,” she explains. “I’m constantly pulled away and distracted, both by my ADHD and by the demands of my kids and household.”
Improved Impulse Control
It’s easy to fly off the handle when you have ADHD. You may blurt things out without thinking or make rash decisions. “It’s important to realize that it’s because your brain is wired differently, not because you’re inherently ‘bad’ or lack willpower,” reassures Hallowell.
People with ADHD have less activity in their prefrontal cortex, which is in charge of your emotional regulation and impulse control. That makes it harder to stop and take a deep breath before you respond to a situation.
Medications to treat ADHD, like stimulants, can help with impulse control, notes Hallowell. You may find that it’s easy to slow down and take a few deep breaths before you respond to a situation or reply to an email.
It’s also important to make sure that you get enough sleep and build in stress management habits like short walks, movement breaks, or deep breathing. “I often recommend to my patients that they wait at least a day before they make a big decision, like a big purchase such as a new car,” adds Hernandez.
If you find that you’ve started to stop interrupting others mid-sentence, resist sudden urges like impulse spending, are less likely to blurt out your thoughts inappropriately, and even feel less compulsion to constantly check your phone, these are all signs that your ADHD treatment is working, reassures Hernandez.
Stronger Relationships
Successful ADHD treatment doesn’t just mean improvements in symptoms. It means improvements in your relationships, too. Research shows that adults with ADHD have more trouble in romantic relationships, and are more likely to be divorced, than adults without ADHD. “An undiagnosed adult with ADHD looks as selfish as can be,” says Hallowell. “They look narcissistic, self-centered, and like they don’t care about anything but themselves.”
Hallowell recalls one male patient in his practice who sought counseling when his wife threatened to leave him over his countless extramarital affairs. “It turns out he had undiagnosed ADHD,” says Hallowell. “That’s not an excuse for this behavior, but it’s an explanation. Once we got a treatment plan in place, he was a completely different person. He was able to save his marriage and his family.”
All adults with ADHD should incorporate therapy sessions with their spouse or partner as part of their treatment, says Justin Barterian, PhD, a psychologist at the Ohio State University-Wexner Medical Center in Columbus, Ohio. “It helps to point out symptoms of ADHD that cause relationship problems, like trouble paying attention, forgetfulness, and emotional outbursts,” he explains. “The couple often falls into a parent/child type relationship, which can be very difficult. We can work together to come up with strategies to help both people feel understood and improve the dynamics.”
Success at Work
If your ADHD treatment works, you can expect to see a significant improvement in your job performance, too. “You’ll find that you are less likely to procrastinate, you are better organized, and you’re able to meet deadlines and show up at the right place at the right time,” says Hallowell. “I always joke to my patients that you can tell if your ADHD medication is working if you can sit down an hour after you take it and read a boring book from cover to cover. But it’s actually true.”
But part of success at work with ADHD is finding a job that showcases your strengths. “People with ADHD need a challenge,” says Hallowell. “But it’s not just to find a challenge — but to find the right challenge.”
He recommends that you sit down and ask yourself the following questions:
- What three or four things are you best at doing?
- What three or four things do you like doing the most?
- What are your three or four most cherished goals?
- What is easy for you but hard for others?
People with ADHD often thrive in independent, entrepreneurial jobs like running their own business, in creative fields like writing or graphic design, or even in high-adrenaline careers like being an ER doctor. “Adults with ADHD do well when they are in environments that they are passionate about,” explains Hallowell. “This way, they can use some of the positives of their ADHD, like their ability to hyperfocus on things they’re interested in, to make it a true superpower.”
What to Do if Your ADHD Treatment Doesn’t Work
One of the best ways to see if your ADHD treatment works is to use a rating scale. A popular one is the Adult ADHD Self-Report Scale. “We recommend that you do it not only at the start of treatment, but also after about a month to see how much you have improved and what kind of symptoms are left,” says Lenard Adler, MD, a psychiatrist who specializes in adult ADHD at the NYU Langone Medical Center in New York City.
How fast you respond depends in part on what medication you are on. “For stimulant drugs, you will know if it helps you within a couple of hours,” says Hernandez. Other classes of medications, like the norepinephrine reuptake inhibitors atomoxetine (Atoncy) and viloxazine (Qelbree) can take about a month before they start to work.
You may also not be on the right dose of medication. “Patients get nervous at the idea that they will take a stimulant, so they ask for the lowest possible dose,” says Hallowell. “Sometimes that’s not enough to have an effect.”
But if you’ve tried several different medications and doses, as well as CBT, and not noticed any success, talk to your doctor about a reevaluation. “We want to make sure that we have the right diagnosis,” says Adler. “Other core symptoms of ADHD, like trouble with executive functioning or emotional regulation, could be due to a sleep disorder. They can also mimic other mental health conditions like bipolar.”
Show Sources
Photo Credit: E+/Getty Images
SOURCES:
Edward Hallowell, MD, founder, Hallowell ADHD Centers, Boston, Massachusetts; author, ADHD 2.0.
Mariely Hernandez, PhD, psychologist, Columbia University Irving Medical Center, New York City.
Justin Barterian, PhD, psychologist, Ohio State University-Wexner Medical Center, Columbus, Ohio.
Lenard Adler, MD, psychiatrist who specializes in adult ADHD, NYU Langone Medical Center, New York City.
Journal of Attention Disorders: “Longitudinal Associations Between Symptoms of ADHD and Life Success: From Emerging Adulthood to Early Middle Adulthood.”
Attention Deficit Disorder Organization: “ADHD Time Blindness: How to Detect It & Regain Control Over Time,” “Pomodoro Timer,” “ADHD Impulse Control Challenges: Symptoms, Causes, and Strategies That Actually Help.”
Journal of Child & Family Studies: “Life With a Partner with ADHD: The Moderating Role of Intimacy.”
UptoDate: “Attention deficit hyperactivity disorder in adults: Treatment overview.”
Neurology Clinical Practice: “Do I Have ADHD? Diagnosis of ADHD in Adulthood and Its Mimics in the Neurology Clinic.”
