What is ADHD?
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition (https://icd.who.int/en, https://psychiatry.org/psychiatrists/practice/dsm), meaning it affects parts of the brain that control our emotions, learning, memory and self-control. Symptoms usually persist from childhood, are present across situations and are often lifelong. For anything to be classed as a ‘disorder’, it must cause problems for the person in how they live their lives as compared to others.
ADHD is characterised by ‘inattention’ and ‘hyperactivity & impulsivity, of which one more be more prominent than the other, or both just as much. ADHD often impacts on what is known as ‘executive functioning’, which includes areas such as:
working memory
time management
planning
problem-solving
attention
self-control
flexible thinking
self-monitoring
decision-making and
controlling thoughts & behaviours.
One of the difficulties often those with ADHD will talk about is the labelling of the ‘deficit’ in attention but then we often forget that people with ADHD can often go into an intense level of focus. A description often used is that of light switch whereby attention and concentration are either off or on for those with ADHD, while for most it is more of a dimmer switch that allows them to turn attention up and down incrementally. Of course, many with ADHD would suggest this ‘on’ switch is more like a full beam flood light as what is known as ‘hyper-focus’ can mean they become so focussed on a task, they get lost in it.
Individuals with ADHD also can be enthusiastic, energetic and highly creative!
ADHD and our surroundings
Individuals with ADHD may struggle more with their physical environment as the way our bodies interpret stimuli through our senses is influenced by our physical environment. For someone with ADHD, they are already often struggling to meet the demands required by completing tasks before the added load of sensory experiences. This means they may be more likely to have their attention diverted from a task by smells, something they see, or hear and even touch. Difficulties in sitting still, concentrating or focusing, becoming easily distracted, difficulties with organisation/time management, forgetfulness, starting and failing to finish tasks are therefore common with ADHD.
The most common first choice or option for treatment presented to those with ADHD is medication. However, the interplay of the impact of ADHD on thinking, feeling and behaviour of individuals have led to several psychological interventions being developed. While studies into the use of psychological intervention remains limited, they have also tended to focus on cognition and emotional regulation in combination with medication. There is little research looking at how strategies for life management and changing our environments to meet ADHD needs could be helpful (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7018471/).
However, as with most things in life, our environments or what we perhaps deem our environments should be, are often set up in such a way to suit the majority, or perhaps more so those with influence.
Do you find yourself going down the YouTube/Pinterest rabbit hole of homes and lifestyles? Do you fawn over the dream of other’s lives but know in your heart that no way in a million years could you ever maintain the pristine whites and light greys… the uncluttered counter tops… the minimalist, streamlined homes… and these people have busy lives and families… how do they do it?!
Someone with ADHD may sit and look out at their own spaces and see the reality of hordes of clutter, piles of disorganised papers, half-started tasks long since abandoned and only dream of the images portrayed in social media.
Another common problem can be switching off and relaxing as environments may be highly stimulating.
Some ideas to consider could include:
Zoning your home or space:
There are tons of ideas on the internet for doing this. Think about how you function in your space. Keep areas for certain tasks – do you need quiet and distraction free space to work? Do you need a calm and uncluttered space for sleeping? Do you need reminders for house tasks? Focus on the sensory needs in the space – think all the senses and use/organise for the level of energy needed in that zone.
Use your space to form habits and routines:
Some people use stations or flight zones – keep everything you need when you leave the house. Keep things in the same place and make it easy for your style. Important daily items like keys, bags, money/cards, and phones should be in a place that you go to every day.
Reduce the load on your thinking:
Energy, creativity, coupled with difficulties in forming plans and structure mean those with ADHD may struggle to start and complete tasks in their homes or other areas of their life. It also means that they can become overwhelmed with tasks and devise plans with too many steps to realistically follow in a set period. When we get overwhelmed, we can shut down or avoid, or sit for hours procrastinating over where to start. Try spending a set amount of time by using alarms to start (overcome that procrastination) and finish (to interrupt the hyper-focus) and work out a simple process for completing a task in your home. Practice this weekly and make it a habit to streamline your processes.
Visual reminders:
Use strategic items in your home as visual reminders. For example, use notes on doors for reminders of what you need before you leave, use simple lists and to stick to one notebook. Often to overcompensate, those with ADHD may make lists of their lists, of their lists, of their lists… and then attempt an overly complex way of organising these with complex colour and filing systems. If this works for you, awesome! If it doesn’t, and you end up in a sea of notes and exercise books, try keeping things to a smaller number of manageable categories.
Organisation:
As aforementioned, some people with ADHD need a visual reminder of something so need their things easy to see, others find having too much on show overwhelming and a sensory overload. What works best for you?
Organising into a reduced number of containers that can be on show and are labelled (text or pictures) of what is inside can be a great way for those with ADHD to have the visual reminder without the visual clutter. Ensure your categories work for you; too few categories to sort your things into and you run the risk of not being able to easily find what you need, too many and it becomes such a chore to organise you easily become re-focussed on something else, then it’s impossible to maintain leading to the piles/clutter building up again.
Try going into each area of your home and work out what you need to do in that space. Then make a note of simple steps that you need to do, add or remove to achieve it. Remember to consider the energy you need or want to achieve in that space and try using what works for your sensory needs.
Also, store things where you need them where possible and in containers (using your big categories).
Keep only what you need for sleep in your bedroom if you can or at least reduce what is in sight.
Make up outfits on Sunday for the rest of the week so you aren’t dashing around.
Make meal plans and a clear list for shopping so choices don’t overwhelm in busy shops or use online if in your budget. Keep these where you will need them.
The psychological benefits of adapting our lifestyle to suit ADHD
Often those with ADHD can feel labelled and because of the difficulties compared to others throughout school and life, they can have a poor sense of self – for example, struggling to get work done on time, underestimating how much time is needed for tasks, not finishing tasks, labels of being a ‘daydreamer’ or ‘misbehaving/fidgety’. These can all take a toll on our mental wellbeing and feeling good enough. For psychological wellbeing, the narrative would benefit from a change to adapting our environments and habits to meet ADHD needs. The repetition of forming simple habits and routines in our spaces could go a long way to helping with this. Make your home or space work for your needs.
Are women with ADHD more likely to exhibit certain symptoms? Would any of these suggest that adapting a home environment might be more beneficial for women, or that women with ADHD might be more likely to do it/more impacted by their surroundings?
Research suggests that more females remain under-diagnosed and that ADHD in females can look different and is often mistaken for other problems for example, anxiety or hormonal. As with any condition, symptoms vary and can vary between genders, of course what is less understood is if these are genetic, biological or because of how society may respond to the symptoms in different genders.
Females are shown to be more likely to internalise their symptoms (inattentive) while males lean more towards externalised (hyperactivity), although obviously there will be differences in the various symptoms for individuals. Research still tends to still focus on external behaviours that interfere with other people and would benefit from looking at the more internalised side of ADHD that can affect an individual’s sense of self and the quality of their life management skills.
There is some evidence to suggest women may be more likely to experience daydreaming, zoning out and can be under performers (due to concentration) or overachievers because of overcompensating for the challenges they face in getting tasks done. Studies have also found that women may struggle with maintaining and succeeding across roles in employment, parenting, relationships and education. While these are also seen in men, the difficulties in organising, following daily schedules, and prioritising needs/tasks within multiple roles are more likely to be managed by women on their own with less reliance on others than men (https://www.psychiatrist.com/jcp/neurodevelopmental/adhd/gender-differences-adult-attention-deficit-hyperactivity/). However, more research and understanding of how ADHD looks in females is needed.
In addition, looking after ourselves and our health can slip given the issues around not feeling good enough, and things not being perfect etc.
· One of the areas that needs challenging in how we talk about women and their needs. Women with ADHD may easily become refocused and direct their attention to the point of hyper-focussing on other things. This could mean important areas of their health can slip their mind, from remembering medications to ensuring they frequently change a tampon! This isn't about being 'lazy', 'dirty' or 'disorganised', it's about how your brain manages information.
· Taking medication, including hormone replacements and contraceptive pills, all are specifically important to the health and wellbeing of women, and strategies such as electronic reminders and smart watches can all be more effective as they are present with us when we need them.
· Just like other areas of health, the nuanced differences for women still require further research and understanding. How do our hormones interplay with ADHD? Our gender roles?
The narrative around women and ADHD, would benefit from a switch from the ‘deficits’ to the things that make neurodiverse women so awesome. Make sure you plan your day for home, work and relaxation. Use blocks of time to complete tasks, organise your space to meet your needs (not the other way round) and most importantly look after yourself & that amazing energy, passion and creativity!
If you feel you want to explore further any symptoms you might identify with regards to ADHD, please see your doctor or a mental health professional.
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