Using a Dopamine Menu to Stimulate Your ADHD Brain

Using a Dopamine Menu to Stimulate Your ADHD Brain

Your brain is a Tesla. When its battery becomes depleted, it needs to stop and recharge. You know the feeling when your power is draining down, but you don’t always know how to replenish it. Many of us grab our phones for a ‘quick’ doom scroll or a game of Geometry Dash. Others eat a cookie. This behavior is understandable, but it’s not helpful. “Most of us don’t spend hours scrolling through social media because we think it’s a good use of our time; we do it because we are looking for the stimulation we need to function,” says Jessica McCabe, the creator and host of How to ADHD, a popular YouTube series, and author of the new book How to ADHD (#CommissionsEarned).

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How to Control Your Anger When ADHD Emotional Reactivity Kicks In

How to Control Your Anger When ADHD Emotional Reactivity Kicks In

Yes, the ADHD brain is wired to overreact and to feel emotions intensely. But you are not your ADHD reactivity. Here, learn how to change your reactive, habitual anger responses with thoughtful, soothing responses.

It starts with a trigger. In an instant, a volcano of anger and negative emotion erupts. Before you can process what’s happening, you say or do things that you will surely regret later. But you can’t stop yourself. If we’re being honest, sometimes it feels good to let it all out. Living with attention deficit hyperactivity disorder (ADHD) means living with a stress-producing condition that begets emotional reactivity.

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Top 4 Mental Health Issues Facing Teens with ADHD in 2024

teens on a benchAs we turn the new page on the calendar and welcome 2024, it’s common for many people to take stock of what happened in 2023 and what changes they would like to see for themselves, their families, their communities and even the world. One topic that many people are thinking and talking about is mental health, particularly for teens and emerging adults. In May 2023, the US Surgeon General published a study on the epidemic of social isolation and loneliness and its negative effects on both physical and emotional wellbeing. With increased rates of anxiety, depression and other conditions, parents, educators, health care providers, clinicians and coaches are not only concerned but also actively engaged in finding solutions and increasing the availability of resources.  In this blog, I want to look at the top 4 mental health issues facing young people with ADHD as well as strategies for how best to support them. As in anything else involving parenting somebody who is neurodivegent, collaborate with them and be an ally. It’s tough to face some of these demons alone and, yet, it can be even harder to accept help. Offer your compassion and your concern while creating a straightforward plan of action.

Depression 

teen depressionDepression involves recurrent, extended periods of negative moods and thinking. Teens and emerging adults battling depression along with ADHD often feel hopeless, misunderstood, and lack energy or motivation. They feel stuck and they can resist any supportive suggestions.  A lot of research suggests that more screen time and social media during the pandemic and afterwards may have caused a rise in depression and suicide among American adolescents. One recent study showed that Millennials and teenagers have experienced the fastest climb in depression diagnosis rates, up 47 percent and 63 percent, respectively. Common signs of depression include:

  • Hopelessness 
  • Loss of energy and motivation
  • Spending increased periods of time alone
  • Lack of interest in activities/friendships
  • Changes in sleep or appetite
  • Difficulty concentrating
  • Physical aches and pains
  • Suicidal ideation

Depression can affect school attendance, work performance, and relationships with family and friends. Social withdrawal due to depression can lead to further isolation for teens with ADHD who may suffer from low self-worth and avoid activities or peers. These patterns make it difficult to break the cycle. If you think that your child, teen or young adult may be depressed, seek help. Start by contacting their primary care provider and get appropriate referrals. Depression can also lead to issues with substance abuse, suicidal ideation, and self-harm. Sadly, it rarely gets better on its own, and, if left untreated, can persist into adulthood.

Anxiety

teen anxietyAnxiety travels very often with ADHD and sometimes it’s hard for kids and their parents to distinguish between the two. It is characterized by persistent, excessive fears or worries about common and non-threatening everyday situations. Sometimes the fears may be rooted in actual events or threatening situations, but the reaction to these concerns is often exaggerated and distorted. In teens and emerging adults, anxiety is characterized by:

  • Constant feelings of worry, tension, unease or dread
  • Restlessness 
  • Irritability
  • Negative expectations
  • Catastrophizing 
  • Physical symptoms like racing heartbeat, shortness of breath, and upset stomach
  • Trouble sleeping

There are many mental health conditions under the umbrella of anxiety which include: specific phobias, panic, obsessive-compulsive disorder and social anxiety. External factors such as bullying, racism, homophobia and excessive social media usage are significant contributors to anxiety in teens and young adults. While ADHD and anxiety are two different conditions, they frequently coexist in kids and teens– around 30% of the time. Untreated anxiety often leads to depression so It’s really important to seek treatment for reducing anxiety. Again, start by consulting with your primary care provider. 

Substance Abuse

teen substance abuseAdolescence and early adulthood are often marked by increased risk-taking and sometimes rule-breaking.  This is a period when many youth begin experimenting with illicit drugs and alcohol for the first time. Sometimes this experimentation can morph from experimentation to substance abuse for kids with ADHD. When something feels good, the reward centers in the brain–those fueled by dopamine-want more of it. The lack of impulse control makes it especially difficult to reign in these cravings.  The most common signs of substance abuse in teenagers can include:

  • Social withdrawal 
  • Behavioral changes, volatility, and irritability
  • Engaging in risky behavior such as unsafe sex, drunk driving, and theft
  • Sneaking out of the house and skipping school
  • Increased tolerance to drugs and alcohol
  • Experiencing withdrawal symptoms when not drunk or high

Substance use and mental health disorders like depression and anxiety often co-occur. In fact, some teens use drugs and alcohol to self-medicate instead of getting the proper assistance with ADHD or other concerns. Teens with ADHD are particularly prone to substance abuse as they struggle with self-regulation. If you suspect that your teen or emerging adult has a substance abuse issue, talk with them about your concerns and then seek out help together. 

Disordered Eating

eating disorderEating disorders are more common for girls and young women with ADHD than for those without it. In fact, they co-occur with ADHD almost four times more often. Eating disorders typically begin during adolescence and can continue into adulthood without effective treatment. While disordered eating is perceived as a problem for girls and young women, boys and young men can also have an unhealthy relationship with food – one which can go undetected or underdiagnosed. Adolescents become more aware of their changing bodies during their teen years and the concept of body image can take center stage. There is a seemingly never-ending stream of images of models and celebrities with “ideal” bodies which are unattainable for most of us. Kids with ADHD who often compare themselves to neurotypical peers are especially prone to seeing themselves as less than. They also may feel a sense of powerlessness and overwhelm due to executive functioning challenges. These and many other concerns can lead to troubled relationships with food. Here are some common symptoms of eating disorders which can develop into bulimia, anorexia, and binge eating disorder:

  • Denying and suppressing hunger
  • Refusing to eat
  • Over exercising
  • Binging and purging
  • Excessive eating and large portions
  • Significant weight loss or weight gain

Eating disorders affect your child’s overall health: specifically nutrition and physical and emotional development. If your teen or emerging adult  is struggling with excessive weight gain, weight loss, or body image issues, discuss your observations about their relationship to food and reach out to a medical professional as soon as possible.

Strategies for Support and Prevention

teen handsSocial isolation and overconsumption of social media contribute significantly to the mental health challenges facing teens. While we can’t escape the dominant culture entirely, we can help teens develop healthy habits for a balanced life. Since we can’t get rid of technology, we want to teach them to use it as an adjunct to their lives instead of the main focus. For example, when kids with ADHD are away from their devices, they need plenty of non-digital options for exercise, recreation and socializing listed for them in plain sight. Otherwise, it can be too hard to remember. Perhaps most importantly, focus on building their confidence. When kids have a strong sense of support and a healthy dose of self-esteem, they are more likely to make positive choices for themselves when it comes to safety. As the saying goes, “an ounce of prevention is worth a pound of cure”.  Here are a few tips to get you there:

  1. Set limits around technology use and stick with them. Make a regular time to turn off devices that give you a screen-free hour before bed. Offer your kids alternatives to video games and social media by doing something together: playing a board game, doing a puzzle, cooking, playing tennis or basketball, taking the dog for a walk or going to a movie. Even watching a favorite show on tv together, while it’s a screen, is something you’re sharing and likely talking about during commercials. Have teens turn their phones into your care each night and give them back at a set time in the morning.
  2. Remind your child that what they see online doesn’t necessarily reflect the truth. No one ever posts pictures of themselves mid-breakout or shares the news that they failed an algebra test. Help your ADHD teen get out of the “compare and despair” trap by building up their social skills. And remind them that face-to-face connections will help them see and understand what’s really going on with someone. 
  3. Guide your teen with ADHD toward self-acceptance. Remind them that we are all perfectly imperfect and have our own unique set of talents, flaws and quirks. When your teen feels loved and supported, they are more likely to make good decisions for themselves. That directly affects the types of friends they have, how they care for their bodies, and how they will manage potentially dangerous situations. Help your teen or emerging adult nurture a positive mindset and gratitude for all that they have and everything that’s going right. A strong sense of self and a resilient attitude will help them get through those dramatic ups and downs of daily life and set them up for health and success well into adulthood.

Mental Health Resources

Surgeon General’s Your Mental Health Information National Institute of Mental Health Suicide and Crisis Lifeline PACER’s National Bullying Prevention Center APSARD’s research on ADHD and Eating Disorders

Ask Dr. Saline: How do I motivate myself and avoid procrastination?

smiling woman on her tablet with coworkersDear Dr. Saline, One of my resolutions for the new year is to be more productive at home and at work. I’m prone to procrastination and think my ADHD is partially to blame. But I really want to get more things done and feel that great sense of accomplishment. Do you have any tips on how I can motivate myself and avoid procrastination? Thanks, Celia

From Dr. Saline:

Dear Celia, woman dusting tableThe beginning of a new year gives us an opportunity to reboot and make a fresh start. We can make a conscious effort to do less of what isn’t working and instead focus on doing more of what is working. Similarly, it’s a good time to tweak your routines to build stronger habits and start the year on the right foot. So kudos to you for looking to improve your productivity as your new year’s resolution. Most adults with ADHD have a tough time working on unpleasant or uninteresting activities. It’s easy to get overwhelmed and avoid stuff until the last minute arrives and you are in a bind.  Sound familiar? Here are my 5 best tips for motivating yourself and avoiding procrastination. Pick ONE of these to try in 2024 and, then, when you’ve made progress with that, try another. Don’t attempt to do all of these simultaneously. Remember, we can really only change one thing at a time. 

Shift to a Positive Mindset

new mindset new results graphicWhile procrastination can be debilitating, the negative self-talk about your lack of motivation, disorganization and overwhelm won’t help you solve problems and complete tasks. In fact, it just piles on more obstacles. But you can change your circumstances by shifting your perspective. Instead of repeating what’s wrong with you, or what you can’t do, what would it be like to think about something that you are good at? Something that you like to do?  A positive mindset means that you are willing to ask “What could go right?” instead of focusing on what could go wrong. You are willing to take a risk, see what happens and learn something. You identify your strengths and lean into them as you address your challenges. You accept that perfection does not exist and, with acceptance, see yourself as work in progress. Just like the rest of us!

Utilize Helpful Incentives 

incentives carrots graphicAn incentive which works for one person may be completely unhelpful for another. An effective incentive is one that works for you. Think about how you’d like to reward yourself when you finish a task or a project so you have something to look forward to as you work. It can be as simple as going for a walk, chatting with a friend or treating yourself to a special latte. Incentives are key to starting a piece of work when you lack the intrinsic motivation to do so. You set yourself to make steady progress and earn some goodies along the way.  Just today, I set a goal to return emails for 30 minutes and then take my dog for a walk since the rain had stopped. The walk was the bonus I needed to get going and keep going. Even though I still had more emails, I went out with my buddy, Milo, once the timer went off. What a relief to leave my computer and meander with him! Then I set a new incentive–dinner–to get me through two Zoom meetings. It’s little things like these that help us tackle our To-do lists.

Break Down Big Projects into Smaller, More Manageable Tasks

task listThe best way to combat procrastination is to break things down into small, doable chunks that seem more manageable. Think of something that you are putting off. How can you break this down into little parts and which one piece can you start with? If you still can’t initiate, the part isn’t small enough.  The smaller the step, the better. Why? Because we are aiming for progress, not perfection. Before beginning a task you’re not all that excited about, tell yourself, “I know I don’t like this, but I know I’ll feel better if I make even a little progress. What is the first tiny thing I can do to begin?”  For example, if you’re facing the very unpleasant task of cleaning a messy kitchen, break it down into smaller chores like putting away food, loading the dishwasher, wiping the counters and sweeping the floor. These subtasks can be completed one at a time and you’ll feel a great sense of accomplishment as you make progress. And if you’re like me, you’ll want to write each task down and then enjoy crossing them off the list when completed.  Breaking work down into smaller tasks helps build your confidence one step at a time because you are performing something instead of avoiding it.

Keep Tasks Engaging

man with headphonesKeep yourself engaged in a task by adding something fun to it–music, chatting with a friend, or collaborating with a co-worker. We call this ‘game-ifying.’ It’s tough for unmotivated ADHD brains to get started on something that seems tedious and boring. What can you do to liven things up a bit? Change the order of tasks, take timed movement and snack breaks, switch locations for working or find an accountability buddy. Also, create realistic goals–ones that you can actually meet and want to achieve. This will go a long way in keeping you motivated.

Notice What Works

man writing in journalConsider keeping a daily journal of three things that went well (or well enough) that day. This can be written or dictated on your phone. This exercise is not about toxic positivity–pretending that things are good when they may not be. Instead, it builds authentic acknowledgement of what is going well and how you’ve some bumps in the day. Then, at the end of a week, you will see your positive actions or events and your productivity. Research has shown that this really helps you shift your perspective and reduce depression (see citation below). So start this year tapping into what motivates you and focus on changing one aspect of behavior related to your productivity. Shift your mindset, use meaningful incentives, break down tasks and notice the good. You’ve got this! Here’s to a strong start to the new year!   Sexton JB, Adair KCForty-five good things: a prospective pilot study of the Three Good Things well-being intervention in the USA for healthcare worker emotional exhaustion, depression, work–life balance and happinessBMJ Open 2019;9:e022695. doi: 10.1136/bmjopen-2018-022695