Adults

Adults with ADHD usually find that there are a number of problem areas in their daily functioning. These problems may not be overcome through the use of medication, or the person may not wish to use medication. Hence, symptoms must be managed through the application of appropriate strategies.

Many problems are centred around issues of organisation, time management and/or motivation. Some of the strategies which may be useful are discussed in this article. Although these strategies may not suit everyone, they may provide ideas which can be adapted to suit particular styles of functioning.

Budgeting is an aspect of organisation which has the potential to cause many difficulties, as limited resources must be stretched to provide for the necessities of life. One of the major areas of expenditure is at the supermarket. To shop effectively, it is necessary to purchase everything that is needed without spending more than one can afford. Most people find it more convenient to do all of this shopping at one time rather than going to the supermarket frequently. In order to accomplish this mundane task effectively a number of skills are required. One way of making sure that items are not forgotten and impulse buying is managed is to make a list of what is necessary. This list may be based on the items shown on the docket received for last week's shopping. If the list is arranged according to the placement of goods along the aisles in your local store, it will be easier to find the items on your list as you shop. It might be helpful to have three columns on this list - the first column for the items, the second column for the number of each item required, and the third column which can be ticked as items are put into the trolley. This list may be refined over a period of time and photocopied so that it serves as an effective shopping list with a minimum of effort. This shopping list will also serve to restrain impulse buying. If there are items on the shelves, which are tempting, but which are not on the list, the shopper needs to ask whether these are items that are needed but and have been forgotten on the list or whether they are not essential but the person would like them anyway. The decision can then be made as to whether this degree of impulse buying is affordable. Please note: There is nothing wrong with a controlled amount of impulse buying since this adds interest to life. However, it is important that the degree of impulse buying is affordable.

Credit cards are the demons in budget wrecking. It is very easy to buy numerous items for relatively small sums of money which can add up to large sums over a period of a month. For example twenty purchases at $50 each adds up to $1000. One way in which expenditure on credit cards can be monitored is to have a small notebook with you every time you use your card. The amount of every purchase can be recorded in the notebook and added periodically to monitor your spending. This is a good idea, but it will break down unless every item of expenditure is recorded. The best way to remember to do this is to make use of a cue. One cue, which is present in every credit card transaction, is the paperwork carried out by the shop assistant and usually signed by the card-holder. Let this paperwork be your cue to write the amount of the transaction in your notebook.

Planning is another aspect of organisation which often causes difficulties for people with ADHD. Once again, a checklist of tasks to be done and items to be taken with you is a useful strategy. If this checklist is filed away (in an organised way of course) it can serve as a useful guide for checklists for similar activities. As with the shopping list, this checklist could be organised into related activities and contain lists of items grouped according to where they are normally kept. This would make the checklist more convenient to use.

It is important that shopping lists/checklists be simple to prepare and convenient to use. If a checklist is difficult to make or inconvenient to use, the ADHD person will not use it, since one of the characteristics of ADHD is a lack of task persistence.

Time management is another area which often causes difficulties for people with ADHD.. They have difficulty in getting to appointments on time. An excellent strategy is the use of a portable kitchen timer. These timers emit an intermittent beep when the set time has expired thus reminding the person that the time is up. They are quite cheap and can be clipped to a blouse or shirt and carried around the house, garden, or workplace. The only condition to their effective use is that it is necessary to respond immediately to the cue and do whatever the reminder was needed for. Otherwise, it is only too easy to switch off the timer and then forget all about it.

Paperwork is an essential element of modern life and we cannot escape it. Most paperwork has a deadline for completion. Families usually find that a small amount of paperwork arrives in the mail each day. If it required an instant response, it would not be too difficult to organise it and keep it up to date. Unfortunately, when it does not have to be dealt with for several days or a week or two, it is easy to put it on one side and then to lose track of it. Again, there is a need for a cue to process the paperwork. The cue might be that, immediately the mail is collected, those items which require a response be placed in a specific place - a folder or case, etc. It is also necessary to organise a cue to ensure the paperwork is not forgotten. Cues can be organised to be effective for each person, but cues such as a regular time each week might be helpful.

Electronic organisers can be very useful in helping people to organise themselves. Most have timers which can be programmed to alert you to carry out some action. They can also store information for later use. Once again, it is necessary to think of a cue which will ensure that you will look at the organiser at appropriate intervals. One cue that might be helpful is to look at the organiser every morning when you are having your first cup of tea or coffee. If you get into the habit of doing this, you will find the organiser a useful aide.

Two important points must be made about organisation. Firstly, don't organise the whole of your life in rigid detail. This is frustrating and annoying, and if you did this, the chances are that you would drop the whole idea of being better organised. Organise what has to be organised and enjoy the freedom of the remainder of your life. Secondly, no organisational strategy will work unless it is implemented regularly. This is difficult for most people to do until it becomes a habit. The only way to ensure that the strategy is implemented is to associate it with a cue as described above. To make this link effective, the response must occur every time the cue occurs.

Impulsivity affects the lives of children and adults with ADHD in a number of ways. Impulsivity may result in unwise financial decisions, or in inappropriate social responses. Impulsivity in minor matters is common to all of us and it usually does not cause problems. In order to avoid unwise decisions in major matters, it is useful to develop a rule that you will not make a response until some later time, which will allow you time to think. Typically, impulsive actions involve a trigger(stimulus) and a response without intervening thought. What should happen is that the stimulus is followed by thinking and decision making before the response occurs. Making a rule that action will not be taken until a later time allows time for thinking and decision making to take place.

Motivation to carry our boring repetitive tasks is difficult for many adults with ADHD. Some have found it useful to make a "To Do List" and to number the tasks in the order they intend to do them. You may find it more motivating to do certain tasks first or last or to do them at a particular time of day. Crossing off each task on the list as it is done can also provide encouragement. Organising a pleasant activity for the time when the tasks are complete can also help to provide motivation.

Finally, one should take account of the frustration, failure and disappointment which most of those with ADHD and their families experience. This often results in their being short tempered and volatile. One technique which can be helpful in handling feelings before they reach "explosion point" is to have a quiet, peaceful place in the house or in the garden. As you feel the pressure mounting, and realise that you are about to lose control, take yourself off to your quiet place away from other people and the situation which has made you angry. Establish a family rule that each member has the right to withdraw to their calm place, and that others should respect this right. Sit quietly until you have calmed yourself, and perhaps think about effective ways of handling the problem. Only when you feel calm and have decided on a course of action which seems appropriate for you should you venture forth.

Copyright Dr Stephen Dossel, and the ADD Association Queensland. This article may be reprinted but should not be modified in any way. Any such use should be acknowledged in the normal manner and must include the author's name and the source of the article.