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I was diagnosed with ADHD in the fourth grade. I don’t remember much about the process other than going to a doctors office that I had never been to before and beginning to take a pill the next day. I don’t remember ever being explained to what the pill was for or why I had to go to that doctor. I believe it was middle school, I can’t remember the exact grade, when I was told that I had ADHD. I remember thinking “Oh that is why I am bad at school” and moving on. I continued to think that way for a long time and I would use it as an excuse as to why I was such a bad student. I wish I would have had someone tell me exactly what ADHD was and how it actually effects me. Here are some things I wish I knew:

1.) That there was nothing wrong with me

I thought something was wrong with me, that I was broken. These thoughts lead to me feeling depressed and unmotivated to do anything. I thought “why even try if I am broken?”. I wish someone would have explained to me that having ADHD was not about something being wrong with you. But in fact that was just a way that I was made differently from other kids.

2.) It isn’t ADHD’s fault

I would blame my ADHD on things. Like forgetting my homework, not doing well on tests, not paying attention in class, etc. Basically anything school related I would blame on my ADHD if I could. I never took responsibility for the things I should have taken responsibility for. I never tried to over come my ADHD because, I didn’t know that was an option.

3.) Why I feel the way I feel

I never understood why my brain felt the way it felt. I was never explained that the hyperactivity part of ADHD can be mental, not only physical. I never know why my brain worked so fast and thought so many thoughts at once. This caused me to day dream when I didn’t even realize I was day dreaming during class. I wish someone would have told me that my brain worked like that, and maybe I could have realized what was happening when it was happening.

4.) Why I had to take a pill

I never really understood why I had to take the medicine other than it was for my ADHD. I wish someone would have explained to me what it was going to, how I could potentially feel on it, and how long it would take me to get used to it. I tried so many different pills at a young age and none of them seemed to work. It was exhausting. I wish someone would have explained why I had to try so many different pills and why they would do what they did.

5.) ADHD is a super power

I wish I knew that at a young age. I wish someone would have told me that despite what I would do wrong, there were so many things I would be great at. I never knew there could be positivity in ADHD until adult hood.

An iceberg is formed when a piece of ice breaks off a glacier and falls into the ocean. Typically only about 10% of the iceberg can be seen above the water due to the fact the remaining 90% is submerged in water. This visual is commonly used to help represent surface level things have a much deeper meaning. Sigmund Freud famously used the iceberg metaphor to help visualize The Theory of The Mind. And since then the iceberg has been used as a helpful visual for many different things.

As I have been researching recently I stumbled upon a visual of the ADHD Iceberg. This visual was created by Chris A. Ziegler Dendy, an ADHD advocate. (Photo from https://www.chrisdendy.com/iceberg)

I have talked previously that ADHD is much more than the acronym itself, and this visual is a near perfect example of what I meant when I said that. Not only is there a lot more under the surface than can be seen, but whatever part of the iceberg is under the surface can be causing what is going on above the surface.

When we notice things like impulsivity, forgetfulness, or fidgety its really easy to stop there and say that is all that individual is. But the iceberg reminds us that there is normally a deeper meaning to those behaviors. And finding that deeper meaning can be so helpful in understanding why those behaviors are happening.

Not only can this be helpful for people that work with individuals with ADHD to help remember that surface level behaviors may be caused by deeper meanings. But it can be helpful for people with ADHD to help understand why they are feeling the feelings they are having or doing the things the are doing. Always try to ask the question “what is going on, what caused this to happen” instead of asking “what is wrong with this person/me.”

I used to really struggle with my ADHD. I didn’t know why I was feeling what I was feeling or doing the things I was doing. It would really frustrate me and lead to a cycle of feeling shame and confusion about what was going on. But now I have the tools and the ability to take a step back and look at the “why is this happening” and the “what is actually going on here.” The more I am able to learn about what is beneath the surface, the more I am able to show up for myself and others around me.

Learning to look below the iceberg has taught me a lot about self-awareness. Self-awareness is not about fixing myself, it is all about understanding myself. The more I can learn about underneath the surface, the more I learn about how to control and navigate what is above the surface.

What is it?

Emotions are one of the many things that set us apart from one another. We all feel different emotions in different situations throughout our lives. People with ADHD typically feel their emotions stronger than neurotypical individuals. Emotional regulation is the ability to manage strong feelings, respond instead of react, stay focused during strong emotions, and to recover have feeling strong emotions. This can be challenging for people with ADHD for many different reasons.

Emotions and feelings may be more intense and be felt stronger. Emotions may cause us to “overreact” to “smaller” feelings. Calming down and getting back on track can be difficult, the ability to move on. Emotions can cause impulsivity often leading to words and actions that are regretful.

This can look different from person to person. And the causes of emotional dysregulation can vary as well. For one person it may come from a place of rejection, causing one to feel overwhelmed. For another person a lot of “small” events may happen that lead to strong emotions. Not all emotional dysregulation manifests in sad or angry emotions. A child in school may get really excited about an activity and they don’t calm down, causing class to be disrupted.

Other triggers for emotional dysregulation may be: loud noises, clothes fitting weird, the weather outside, too many people around, not eating or eating too much of something, the temperature in the room, and many more things.

Tools to try

Name the emotion: Have the person experiencing emotional dysregulation name what emotion they are feeling. If they can name it, that can help to redirect and calm down.

Stop and think: Take deep breaths and even walk away if needed. Count to 10 and talk yourself down. Or talk to a trusted individual about what you are a feeling. For a student this may be their teacher at school

Body regulation: Walk around to get some energy out. Or sit with a weighted blanket for some deep pressure.

Calm down corner: In a classroom or at home have a designated place to calm down and regulate.

Model and practice: Model with students and children how to regulate when feeling dysregulated

What is it?

Time management is one of the biggest struggles with ADHD. Dr. Russell Barkley has been doing research on in the world of ADHD and has identified time management as one of the primary executive functioning deficits.

Time management is the ability to use time effectively, estimate time accurately, prioritize tasks and deadlines, and start and finish things according to a schedule. It is more than just being on time for an event or finishing a project on time, it is seeing time as something real and structured. Many people with ADHD struggle with time management in many different ways.

“Time blindness”has become a pretty popular term in recent years. This is where an individual may underestimate or overestimate how much time something is going to take. there are many examples of time blindness; maybe it is driving to a destination, how much time is needed to complete their homework, doing the dishes before leaving the house. This can also feel like there are two times “now” and “not now” and everything that needs to happen gets shoved into one of those times. Then relying on urgency when a deadline gets closer. When a deadline finally arrives the the “not now” project gets put into the “now” category. I have fallen victim to this so many times its crazy

As I mentioned earlier time management effects individuals with ADHD in many different ways. It could be always being late or early to everything. Forgetting appointments or important deadlines at work. Hyper focusing on one thing that distracts you causing you to miss your deadline. Struggling to find an effective pace to complete a project.

Tools to try

Timers: Create a visual timer to show a projects deadline

Chunking: Breaking big projects into multiple pieces over a long period of time

Alarms and reminders: Set reminders for appointments or daily tasks

Visual schedules/calendars: List tasks that need to be completed in order and mark them off as they need to be complete

Make it a game: Start a stop watch and race to complete a more mundane task, like folding the laundry. (I hate folding the laundry)

What is it?

Organization is the ability to keep track of things both mentally and physically. It is much more than just keeping everything “tidy”, it is arranging materials and thoughts logically. Knowing where everything goes and how to meaningfully group information together. With organization it is important to remember that it is more than physical space that has to be organized but mental space as well.

I’ve shared before what my brain feels like by picturing that scene in Jurassic park where Mr. DNA is surrounded by code numbers going all over the screen insanely fast. So imagine that happening while trying to organize a desk, you’re going to end up with something that looks a lot like my desk now, organized mess. Is it neat and tidy? Nope, but it is organized in the sense where I know where everything is. Is it organized logically? Nope, not at all.

And that’s just one example of physical materials. Organization can also mean keeping track of assignments, deadlines, instructions, or time. Or it could mean creating a routine to follow and stick to it.

For those of us with ADHD it isn’t about wanting to be organized, trust me I do WANT to, its about how our brain files things, we don’t have a clear mental sorting system.

Tools to try

Labels: Create labels of where things need to go

Chunking: Breaking up tasks or deadlines and doing a little at a time

Visual Schedules: Use pictures and time stamps to help keep to a routine

Visual Organizer: Similar to a schedule but for projects to structure thoughts before starting

What is it?

Task initiation is the ability to start a task without procrastination. It is more than being to lazy to do something or wanting to do something, it’s about taking the first step to complete a task. This could be due to many reasons. The task may feel huge to the individual, the task may be unclear, the individual may not understand what the point of the task is, or the task could just be boring to the individual. Taking the first step to start a task is often the hardest part for individuals with ADHD.

Task initiation is related to three of the areas we’ve already covered; working memory, planning, and impulse control. Remembering the steps to complete the task in a logical order. And having the ability to control ones impulses to stay on the task at hand.

As I discussed earlier individuals with ADHD may not know where to start a task, making it feel more intimidating than it is. The task may feel too big to all do at once causing the individuals brain to freeze and not know where to start. The brain may not recognize the task as urgent and put it off until the brain recognizes it, making the individual feel “ready” to begin the task.

Task initiation can come up for individuals in many different areas. It could be something as seemingly simple as making the bed in the morning, it could be a student starting their math homework, it could be starting a new house project, or writing a super cool ADHD blog. And some tasks may be easy for individuals to start, especially if it is a task one may enjoy. It’s all about how the individual views the task at hand.

Tools to try

Chunking: Breaking the task into small pieces

Timers: Set a 5 minute timer to work then take a 5 minute break then work again for 5 minutes. Repeat until the task in finished

Visual cues: Write all the steps that need to be completed on cards or sticky notes and remove them as the task gets completed

Body doubling: Have someone sit with you that needs to complete tasks too and work together but separate to complete your individual tasks

Launchpad: Do a small task that is similar to the big one you need to complete. Making it seem easier to complete the big one after you complete the small one

What is it?

Planning is the ability to set goals, think ahead, decide what needs to happen to reach the goal, and organize those steps in a logical order. Planning can be seemingly simple things like, going to get groceries, cleaning the kitchen, or taking out the trash. It can also be bigger things like, leading a meeting at work, starting a really cool blog, or building a shed. People with ADHD struggle with this in many different ways. And it isn’t just a matter of laziness, lack of motivation, or disorganization.

People that fall on the ADHD spectrum struggle with this for a variety of reasons. Sometimes the brain has trouble visualizing logical steps to complete the task. It can be hard to prioritize what to do first. It could be a matter of motivation due the process feeling unclear or overwhelming. When the plan starts to feel overwhelming, it can start to feel irrelevant. It isn’t because we don’t want to plan things, it’s that our brain kind of freezes before the plan can even be started.

This can look different in each individual and can vary for each plan. It can look like procrastination, “I’ll start this later”, and then rushing to follow through with the plan at the last minute. Starting projects can be hard if there is no clear goal or order. Not knowing where to begin in a project or plan can be a factor too. Or forgetting the steps to complete the project.

Planning differs from organization. Planning is all about sequencing, doing what needs to be done and when. Organization is all about structure, everything has its place of where it needs to go.

Tools to try

Visual planners: I know I say this a lot but they are so helpful. Especially with planning. Seeing each step broken down into smaller pieces and completing them one at a time. This can also be known as “chunking tasks”.

Timers: Setting a time to complete the task. Then taking a short break and coming back to it with the time set again.

Backward planning: This is more situational but start making the plan from the end goal and plan out all the steps backwards. Then start at the beginning.

Talk it out: Talking it out with someone, or yourself aloud, can be very helpful to take some load off the brain of only visualizing it.

Stick notes: Writing the steps out in the order they need to be completed and then taking them off one at a time after they have been completed.

What is it?

Cognitive flexibility is the brains ability to switch topics, ideas, tasks, or rules. It’s the skill that helps us to adapt to changing plans, take on a new point of view, or thinking about something in a new or different way. For those of with ADHD this is harder to do. It’s kind of like switching lanes in traffic but we don’t have a working turn signal. This sounds a lot like stubbornness doesn’t it? While they may look the same on the outside they come from different places mentally.

Stubbornness is typically intentional and a form of refusal. It normally comes from a place of pride or defiance. Stubborn people can adapt but simply refuse to.

Cognitive inflexibility, the opposite of cognitive flexibility, is neurological and not behavioral. It comes from a struggle to shift ones thinking, not a refusal. To an individual this can feel distressful or overwhelming. There is a desire to adjust but the brain is saying “wait this isn’t what we planned.” A person with ADHD can adapt, it is harder for the brain to do so.

This can look different in every individual with ADHD. For children it could look like switching from play to work at an unplanned time. Or if plans change due to unforeseen circumstance (outside time got canceled due to rain.) Plans changing can already be overwhelming enough. Now add something neurologically rooted, like executive functioning, and you get cognitive inflexibility.

This is a big one for me personally. My brain really likes to focus on plans and things coming up. And sometimes my brain makes “the perfect plan or way” something is going to play out. Now when that thing doesn’t happen and I have to adapt my brain starts to go “Whoa! Hey this is not what we planned buddy.” And thus the overwhelming feeling begins and everything stops being fun. I’ve been able to work on this recently and what has helped me has just been telling my brain “Hey I know. It’s okay for things to change and it is still going to be a great day.”

Tools to try

Transition timers: Using these are great for anyone with ADHD. Telling the brain that there is a change coming in x amount of time can give the brain plenty of time to adapt.

Visual schedules: Very similar to timers. Giving someone a heads up about what is going to happen during the day. Giving the brain plenty of time to get ready for the day.

Teaching flexibility: Especially great for children. Children already aren’t great at being flexible with changes. Teaching our students and children how to be flexible can be huge and the pay off could be great as they grow up and their brain develops more.

Explain the why: People are naturally curious and those with ADHD are even more so. Explaining why the plan has changed can help the brain adapt to the new change.

What is it?

Impulse control is exactly what it sounds like, the ability to controls ones self, thinking before doing. This would include actions like saying without thinking, doing without thinking, reacting without thinking. Really doing anything without thinking of the outcome of the actions. People aren’t without impulse control, it is simply weaker than neurotypically developing people. This is due to how the brain develops and regulates chemicals like dopamine.

The prefrontal cortex of our brain develops slower and is overall less active due to ADHD. So when those of us with ADHD react most of the time we are doing it before our brain can go “Stop and think”. This also effects how dopamine is produced in the brain. We have lower dopamine levels or the brain uses dopamine less effectively. This correlates with saying or doing before thinking.

Impulse control relies on being able to be patient and waiting for gratification. Ineffective dopamine regulation makes the waiting part much harder, and sometimes it isn’t even realized. So when a person says or does something out of impulse it’s that dopamine taking over and saying “do this now it’ll feel good” so that thing ends up being said or done.

This can be seen even stronger in children with ADHD due to how their brain is developing. Sometimes it can look like a behavior issue, and sometimes it is that, but a lot of the time it is simply a neurological difference.

How can we tell the difference? Sometimes it is hard. Looking at the “why” is very important. Maybe the space is too quite so an individual may start humming and not realize it, they are trying to fill a silence they don’t like. Or maybe an individual has sat still for so long during someone reading that they just feel the desire to stand up and spin around. Their brains are trying to compensate for a lack of dopamine.

I’m not saying to excuse any kind of outburst from an individual with ADHD. But if we look at “why did this happen” we can help give that individual tools to use so that behaviors that may seem like acting out don’t happen as often or even at all.

Tools to try

Physical movement- Give the individual a fidget to use when they are supposed to be sitting still. This can help to get out some of that energy the brain can be telling the body to use. If they are sitting in a chair but moving around a lot in it, try giving them a wobble stool or letting them stand and work.

Visual reminders- Pictures of a stop sign or a hand being held up in a stop position that say “think first” could help students to remind them that they need to think before they do. Teaching them to think “Is this okay to do right now?” If the answer is no, then don’t do it and use a tool, like a fidget.

Educating- Sometimes individuals may not know or realize the things they are doing. Teaching these individuals that they are doing these things and when they are doing can be a big help in them understanding how to correct the behavior next time.

Rewarding- This can especially be great in the classroom setting this can be huge. If you notice a student that normally would start to hum or get up and move around wait until recess to get their energy out or go get fidget and use it appropriately, like a tool not a toy. Reward the student and tell them how great it was that they used their tools and strategies. Being rewarded for waiting can be huge for dopamine regulation.