The ADHD Sandwich Generation: Unique Challenges of Multigenerational ADHD

mutligenerational familyDo you feel overwhelmed by parenting responsibilities and the needs of elderly parents? Then you are smack in the middle of the sandwich generation. Given there are hereditary factors to ADHD,  if you have ADHD, chances are your parents and your kids likely have it in varying degrees, diagnosed or not. This presents a unique set of issues for the “sandwich generation” – when you are raising children as well as caring for aging parents.  There are several challenges of multigenerational ADHD. For example, issues around executive functioning (EF) and working memory manifest differently in kids, the elderly, and in midlife. Children may struggle with completing homework assignments while seniors may forget to keep up with medication regimen. And you, caught in the middle, need to juggle work and caretaking duties as well as taking care of your own health and wellbeing. That’s a heavy load to carry even if you have the support of a spouse, friends and colleagues. So how can you make things a little easier for yourself? How can you equip yourself to take care of yourself as well as those of others when ADHD can make things more complicated?

Manage Time Effectively

time planning notebooksOne of the hallmarks of the ADHD sandwich generation is that it’s a nonstop juggling act where everything feels urgent and necessary. When things are coming at you from all sides, it’s easy to get overwhelmed. Your to-do list of competing priorities seems to get longer and longer.  Start by zooming out: when you pull back and take the bird’s eye view, what stands out as your priorities. Write these down. Then assign dates when you would like to accomplish certain tasks and dates when things are absolutely due. Then prioritize them and create an order based on deadlines. This will relieve some of the pressure that you feel. Next, find strategies for tasks by improving productivity with ADHD with stronger time management. Use backwards design by starting an end point (arrival time, due date, etc.) and subtracting how long each part of the task will take. Be honest with yourself when you are estimating this. Then, using time blocking, set aside a chunk of time to do ONE thing at a time, shutting off distractions like alerts from your phone. When you complete something, check it off and take a moment to enjoy that.  There’s no one size fits all solution. Setting up morning and evening routines for yourself and/or your kids could relieve a lot of stress and save loads of time. Using online calendars, organization apps or whiteboards can help your ADHD brain get organized and stay on track. Once you schedule tasks by writing them down, you don’t have to keep thinking about them or using up precious energy worrying about forgetting something. Practicing how to plan and prioritize effectively  leads to game changers in daily life. These strategies might take more extra work up front, but will save you time and energy in the long run.

Delegate and Ask for Help When You Need It

mom giving sun cleaning suppliesFolks with ADHD often find it difficult to delegate tasks or ask for help. Typically, this comes from  fear and shame about looking weak and incapable. In fact, this couldn’t be further from the truth. We all rely on getting some help and support in our daily lives, with or without ADHD. Everybody has strengths and weaknesses and people get things done through collaboration and guidance. So when you feel overwhelmed, lost, or just in need of some relief, it’s important that you advocate for yourself, delegate and ask for help with confidence. Certainly there are some things only you can do. But what about the rest? Make a list of tasks you could delegate to others. Start at home: what are some things your spouse or kids can help out with? Are you doing things for them which they could easily do on their own? Next consider what you can ask a friend or neighbor to do here or there. If it feels like an imposition, offer to swap or take turns. Car pools and grocery runs are two easy chores which you and a friend can switch off on. If you work outside the home, think of who and what can help you overcome ADHD challenges at work. Is there a coworker, manager, or mentor you can turn to for support? Remember, there is no shame in asking for help when you need it. Teamwork makes the world go around.

Take Care of Yourself

woman exercising on floorTaking time for yourself is not a luxury to be sacrificed. It is a necessity. If you are not in good physical, mental or emotional shape, you’ll have a much harder time keeping up with life’s many demands. Plus, you won’t be able to take care of your family the way you’d like. Self care has to be a priority so you don’t experience burn out. Otherwise, you’ll always push that down to the bottom of the to-do list and never get to it. Self-care is essential for building confidence, resilience and stress tolerance. Consider what you can do in times of stress which will help calm and center you. Getting out in nature and doing some form of exercise are two extremely effective tools for stress management. Meditation, journaling, time alone or time with friends are additional ways to take yourself out of the daily routines. Decompression isn’t a luxury; it’s a necessity. What does this look like for you? Suggest and brainstorm some of these practices to your loved ones as well. The more grounded they feel, the better for everyone in the family, including you! If you’re not able to carve out a little time for yourself during the week, schedule wellness activities on weekends. Even sneaking in 30 minutes of quiet with tea and a good book will provide you with fuel to face the day’s challenges.

Keep Your Sense of Humor

laughing woman outsideSometimes life can feel like a blooper reel. For most of us, days consist of interruptions, mistakes and misunderstandings. While these can feel daunting, much of the time these are manageable challenges which require a little elbow grease and creative problem solving. It’s helpful to keep things in perspective by zooming out and reflecting on what is most important to do right now and what can wait.   On days when you’re putting out one fire after the next, a sense of humor can certainly help get you through it all. Of course an illness or a broken car is a serious matter. But often big challenges can be temporary. Remind yourself that you’ll get through this. You have many of the resources you need and, if you don’t, you can ask someone for assistance. Try to think back to another difficult circumstance or a difficult day you had. What or who helped you get through it? How did you help yourself? Can you do more of that? Some days are just so tough you have to laugh about it and power through. As the saying goes, try not to sweat the small stuff. Instead, shift your focus to brighter days ahead.

Ask Dr. Saline: How Can I Stop Emotional Meltdowns As an Adult With ADHD?

angry manDear Dr. Saline, I’m an adult in my late 50’s and have finally been diagnosed with ADHD. One of the behavior patterns I’ve struggled with over the years is emotional meltdowns. I get easily overwhelmed by stress, worry, or uncomfortable social situations. At first I get irritable, then it builds up to anger and eventually I just snap and lose my temper. I know it affects my family life and would like to do better for them and for myself. Any tips? Thank you, Kevin

From Dr. Saline:

Dear Kevin, emoji blocksIt’s wonderful that you have been diagnosed and are working on making positive changes for yourself and your family. Anger is often a difficult emotion to manage for kids and adults with ADHD. Regulating intense emotions can be extra tough in the heat of the moment when your ADHD brain goes into overdrive. It’s hard to hold it together when you’re angry, frustrated or afraid. You may know you’re supposed to stay calm, take a break or practice breathing exercises, but that all flies out the window once you’re triggered. Instead, you may yell, cry or say inappropriate things which you’ll probably regret later.  You already have the self-knowledge and awareness about your emotional dysregulation at times of great overwhelm. So you’re most of the way there! In order to gain more control over your emotions in the moment, you’ll need to practice a 4-step process I call “STOP-THINK-ACT-RECOVER”. The basic idea is that you stop long enough to notice the oncoming emotional meltdown, think about what’s happening and what other choices you could make, take a different action or approach and set aside time to recover and integrate. Let’s take a closer look at this technique.

Regain Emotional Control with “STOP-THINK-ACT-RECOVER”

Self-regulation is tough for folks with ADHD. The swell of emotional triggers take over the portion of the brain that helps us regulate and remain steady. The ADHD brain, with its ‘now/not now’ switch, may not recognize the triggers until it’s too late, leading to emotional flooding. STOP-THINK-ACT-RECOVER is a technique which will allow you to learn to identify and respond to emotional triggers and manage angry outbursts more intentionally. Think of it as your internal GPS which will guide you away from the oncoming storm and toward quieter shores.

STOP:

hands making stop sign

In this step you practice self-awareness. You notice the physiological signs that you are activated. You may feel your heart rate increase, notice perspiration and hear your voice growing louder. Catch yourself as soon as you’re aware of your physical symptoms and mounting emotions and stop before you melt down. If possible, go to another room or step outside. Take yourself out of the environment which is creating stress. If you’re interacting with other people, it’s ok to say, “I’m feeling a bit overwhelmed and need to take a little breather to gather my thoughts.” 

THINK: 

woman thinkingNow that you’ve stopped the oncoming meltdown and put yourself in a neutral environment, take a pause long enough to regain your composure and gather your thoughts. Use metacognition to reflect on your thoughts and experiences. Take a few deep breaths and consider what’s most important right now. If you need to respond to an upsetting email, consider composing a few drafts to get your thoughts out. If you need to get back to a conversation, think about what might be a genuine response that isn’t offensive. Decide what the next right thing to do is.

ACT:

ACT graphicHere’s where you engage in doing that next right thing. You redirect your actions toward others in ways that are more constructive. These can include making repairs or simply moving onto something else. Either way, you are making a choice that is different from your typical reactions. Instead of yelling at your spouse or child, take the time to breathe deeply, speak calmly and share honestly.

RECOVER:

woman sitting on mountainGive yourself time and space to recalibrate. There is no need to rush and process anything. In fact, having some distance between an emotional meltdown and talking about it can be really helpful. Everybody has settled down and sometimes people have moved on or are more comfortable being accountable. After a few hours or maybe the next day, you (and those around you) will be better able to have an effective and clarifying conversation. ADHD or not, we are ultimately responsible for our reactions and behavior. We may not be able to control an unpleasant situation, but we can learn how to manage the ways we choose to respond. It’s the power of choice that needs to be the target of your focus, not self blame or shame. When you equip yourself with the necessary tools to manage anger, you will feel better about yourself, improve social relationships and increase productivity. And most importantly, you will help restore calm and connection within yourself and for your family.

“I wish more people understood how it felt to be neurodivergent”: What to Know About Neurodiversity

Time for a societal change? Awareness of neurodiversity is one step, acceptance and valuing these differences are the goals. This would mean a shift from ‘corrective’ behaviour therapy offered by Early Intervention centres. Here’s what to know about the Neurodiversity movement.

‘There is nothing wrong with being neurodiverse. It is simply a different way of thinking. Some of the greatest minds in history are suspected of being neurodiverse and their discoveries have changed the world. If as a society, we could find a way to embrace neurodiversity and support individuals rather than treating it as a problem to be solved, we might be a lot further in finding solutions for some of the major problems we are currently facing’ says Donna who is neurodivergent herself and has two neurodivergent children. As Autism Acceptance Week (previously referred to as Autism Awareness Week) nears, two mamas and Speech and Language Therapists Fátima Ionescu and Melanie Muttit advocate for a societal change to move from awareness of autistic individuals and neurodiversity to acceptance, support and inclusivity instead. The autistic community would like us to move away from Autism Awareness and instead to Autism Acceptance due to the ableist views and perceptions created by Autism Awareness Day. This would also mean not aiming to “fix” or “correct” neurodivergent attributes and characteristics as some Early Intervention centres aim to do and instead looking for neurodiverse-affirming approaches

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How do I avoid the perfectionism trap?

Dear Dr. Saline, I recently started my first full-time job after graduating from college and feel like I’m struggling with the adjustment. I’ve had the usual ups and downs in school which come with ADHD. But now that I’m working, my tendency toward perfectionism has become overwhelming. Worst of all, I don’t think my work is any better as a result of all the extra effort I put into it. Do you have any advice on how I can get unstuck from the perfectionism trap? Thank you, Kathy

From Dr. Saline:

Dear Kathy, First of all, congratulations on your first full-time job! It’s an important milestone, and it’s natural to take time to figure out new routines and skills as you make this transition. Wanting things to go well reflects your desire to do well. But when this desire morphs into a need for everything to be just right, anyone can tip over into complicated perfectionism. Perfectionism is a common issue for kids and adults with ADHD who simply want to avoid making another mistake (again). While banishing perfectionism forever may be your goal, it’s not that realistic. Instead, you can learn to turn down its noise and create more effective coping strategies for motivation and quality.

Perfectionism and ADHD

For folks with ADHD, perfectionism can be a way to overcompensate for feeling not good enough or being “less than.” It’s also a way to hyperfocus on a task, project, or idea as you push yourself to get “just right.” The trouble with perfectionism is that it can be a double-edged sword. When used productively, it can be a driving force in helping you do your best work. But it can also create a great deal of troubling anxiety that actually hinders progress. It’s all too easy to get stuck on one detail, go down a rabbit hole, and then lose sight of the bigger picture.

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