Daniel's Notes

How to ADHD

21 min read

Resources from the Book

My Notes

Introduction [00:00:10]

  • The author, Jessica McCabe, explains why she wrote “How to ADHD” despite having ADHD herself.
    • ⭐ She wanted to consolidate and preserve her knowledge gained over seven years.
    • ⭐ The goal is to provide a user’s guide to ADHD, offering insights, research, strategies, and validation.
    • ⭐ The book is intended to be ADHD-friendly, with short paragraphs, reading shortcuts, and quotes from the How to ADHD community.

Chapter Divisions [00:04:12]

  • ⭐ Almost every chapter is divided into four sections:
    • The Experience Of: [00:04:22] Personal and relatable experiences.
    • What I Learned: [00:05:15] Easy-to-understand science communication.
      • ⭐Jump off point for more learning: howtoadhdbook.com [00:05:51]
    • The Toolbox: [00:06:00] Research-backed strategies.
    • The Ending Anecdote: [00:06:57] Perspective shifts.

Brains and Hearts [00:07:37]

  • 🗣️ Viewers are called “brains” and those who love someone with ADHD are “hearts.”
  • ⭐ There is a chapter dedicated to “hearts” to help them understand ADHD.
  • Paradoxically, being functional means behaving in less neurotypical ways.

A Note on Language [00:08:56]

  • Accessibility is prioritized when it comes to language.
    • Language that attacks, shames, or silences is not used.
    • Language that creates access is used.
      • e.g., “disability,” “impairments,” research-based terms, and colloquial language.
  • Brain holder’s choice is what they call language with their own spin.
  • Person-first and identity-first language are both used.

Chapter 1: How to Fail at Everything [00:16:18]

  • The author felt like she was failing to be the person she was supposed to be.
    • High expectations frustrated the author and others when basic expectations weren’t met.
    • Examples of exceeding expectations: Reading comprehension at post-high school level in 3rd grade, raising ducklings for an English class essay.
    • Examples of failing basic expectations: Struggles with basics such as keeping her room clean and homework done.
  • Acting career and career path issues are discussed.
    • Frank discussion of disordered eating [00:24:36]
    • The author carried her shame and frustration with her into the audition room.
    • In 10 years after college, the author quit or was fired from 15 jobs.
  • At 30, the author couldn’t even keep her car clean.
    • Her glove box was full of unpaid parking tickets.
    • Her marriage lasted four months.

The Author’s Negative Beliefs [00:27:42]

  • The author internalized beliefs that she was irresponsible, messy, and careless.
  • The author was diagnosed with ADD around 12 years old.
    • It helped her GPA go up a whole point, but medication added new expectations.
  • The author dropped out of college because she forgot to sign up for statistics.

The Toolbox of Ineffective Strategies [00:32:40]

  • Deny
  • Apologize
  • Beg
  • Try to do better next time
  • Try harder

The Turning Point [00:37:13]

  • At 32, broke and living with her mom, the author realized what she was doing wasn’t working.
  • Life coach Alison Robertson challenged her belief that she had to change to be successful.
  • Alison told her to stop doing everything and realized she needed to figure out why it wasn’t working.

Chapter 2: How to ADHD [00:41:51]

  • The first thing that happened when the author started her YouTube channel was learning she doesn’t have ADD, but ADHD.
  • The author was diagnosed with ADHD combined type.
  • She had no idea that showing up late, not staying organized, etc., was related to ADHD.

What the Author Learned About ADHD [00:47:40]

  • ADHD is incredibly misunderstood.
  • Research and publishing peer-reviewed papers takes time.
  • Many people think ADHD is less serious than other mental health conditions.
  • Misinformation spreads quickly.

Common Misconceptions about ADHD [00:49:00]

  • ADHD doesn’t involve an attention deficit, but the inability to regulate attention.
  • You don’t have to look hyperactive to have ADHD.
    • There are three presentations: Primarily inattentive, primarily hyperactive-impulsive, and combined type.
  • ADHD is a neurological issue, not behavioral.
    • Rewards, not punishments, are more effective.
  • ADHD has a serious impact.
    • It can affect life expectancy and make lives harder and shorter.
  • There is no one solution.
    • The optimal treatment for ADHD is multimodal (therapy and medication).
    • This can include skills training, psychoeducation, and support.

Why People with ADHD Struggle [00:59:06]

  • Stigma around ADHD.
  • They’re held to the same expectations as neurotypical peers.
  • Their symptoms are something everyone struggles with.

The Toolbox: New Approach [01:06:20]

  • Take ADHD seriously.
  • Connect with others.
  • Work with your brain, not against it.
  • Keep going.

Chapter 3: How to Hyper Focus [01:15:09]

  • Author’s early struggles with focus in school.
  • Metaphors of focus as a mythical creature.
  • Doctor prescribed stimulant medication, but the teacher said they thought I was too smart to have ADD.

What The Author Learned [01:43:28]

  • ADHD is a terrible name for the condition, attention deficit implies a lack of attention.
  • We’ll learn more about this later.
  • ADHD can look like a kid bouncing off the walls.
  • It can also look like a full-grown adult unable to sleep because of racing thoughts or a child staring dreamily out a window.

The Toolbox: Strategies to Help

  • Boost the signal and decrease the noise. [01:06:20]
  • Practice nonjudgmental redirection. [01:06:20]
  • Make space for hyper focus and install guardrails. [01:06:20]
  • Move your body. [01:06:20]
  • Rest your brain. [01:06:20]

Chapter 4: How to Executive Function [01:46:17]

Introduction: The Fantasy of Organization [01:46:34]

  • ANECDOTE: Author describes moving to new office and falling into familiar fantasy of “finally getting organized”
  • Reality check: Not truly starting from scratch - bringing habits, routines, brain, and chaos [01:47:01]
  • Childhood pattern: Setting up organizational systems that fell apart within weeks [01:47:17]
  • Adult pattern: “ADHD New Year’s” with new purses, apartments, desks, hobbies, careers [01:47:39]

Why Systems Fail [01:48:14]

  • Common reasons for system breakdown:

    • Forgetting to use it or how to use it
    • Losing it
    • Getting bored
    • Forgetting it exists
    • Misplacing important items
    • procrastination
    • distraction
    • Technology issues
    • Financial constraints
    • Life disruptions

  • Response to failure: Sometimes maintaining perfect organization through obsessive control [01:48:58]

  • Trade-off: Could only stay organized by not letting life happen [01:49:38]

Understanding Executive Function [01:51:03]

Definition [01:51:10]
  • “executive function (EF) is like the CEO of the brain. It’s a set of top-down cognitive processes, executive functions, that help us self-regulate so we can effectively plan, prioritize, and sustain effort toward long-term goals.”
Key Aspects [01:51:33]
  • Originates in prefrontal cortex
  • Typically develops by age 25 in most people
  • ⭐ executive function is impaired in ADHD brains
Core Executive Functions [01:52:30]
1. Response Inhibition [01:52:37]
  • Definition: “response inhibition refers to the suppression of actions that interfere with a goal, or are inappropriate, or no longer appropriate in a given context.”
  • Creates mental space between stimulus and action
2. Working Memory [01:53:18]
  • Definition: “working memory refers to our ability to temporarily hold information in our mind, manipulate it, and produce a response or action.”
3. Set Shifting [01:53:44]
  • Definition: “set-shifting” (AKA task switching) refers to our ability to switch between tasks that have different cognitive demands”
  • Moderately impaired in ADHD
Hot vs. Cool Executive Function Systems [01:56:30]
  • Hot EF: Affective and motivational processes; active when emotions/stakes are high
  • Cool EF: Cognitive processes like response inhibition, working memory, and set shifting
  • Both can be active simultaneously, though one typically dominates

Solutions and Tools [02:00:30]

1. Have Less to Manage [02:00:55]
  • ⭐ Common saying amongst ADHDers: “If you want to do more, do less”
  • Reduce what needs to be tracked and managed
2. Delegate Areas of Responsibility [02:01:20]
  • Focus on delegating entire areas rather than individual tasks
  • More efficient for executive function
3. Keep Systems Simple [02:01:51]
  • Avoid elaborate organizational systems
  • Example: “Books go on bookshelf” vs. complex sorting systems
4. Practice Minimalism [02:02:20]
  • Own less stuff
  • Easier to manage clutter with fewer possessions
5. Account for ADHD Tax [02:07:21]
  • Definition: Additional expenses incurred due to having ADHD
  • Includes financial costs, energy, time, and other resources
  • Examples include late fees, rush shipping, replacement costs
6. Build What Works for You [02:11:49]
  • Create systems for who you are, not who you want to be
  • Consider:
    • What’s worked before
    • Current habits and preferences
    • ADHD-specific needs

Manual Mode vs. Automatic Mode [02:14:34]

  • Author’s personal experience as a server
  • Impact of system changes on executive function
  • Importance of maintaining stable systems while implementing changes
  • Allow time for new systems to become automatic [02:17:52]

Chapter 5: How to Sleep [02:18:00]

  • There is a discussion of all the odd places that someone ends up sleeping while suffering from ADHD.
  • As an adult, I kept the same pace.
  • There was always more I could be doing for my career, for my parents, for my partners, for my friends, for my financial health, for my physical appearance and for my future.

The toolbox [01:15:09]

  • Prioritize the right amount of sleep.
  • Practice good sleep hygiene
  • Motivate yourself to sleep.
  • Work with your chronotype.
  • Have a Backup Plan.

Chapter 6: How to See Time [02:16:20]

  • Inability to comprehend the value of time is discussed.
  • Not being able to stick to a time, despite having a schedule is discussed.
  • An important message, If something sounds fun and good, it might just not be that.
  • I needed and you have a great chance of making everything work.
  • Have a good day.

toolbox.

  • It now made sense why my old approach to ADHD didn’t work terribly well for me.
  • Trying harder didn’t account for how hard I was already trying.
  • It also didn’t account for the fact that I have ADHD, which affects many aspects of my life and much more significantly than I’d realized.
  • Now that I understand this, I take a much different approach to my struggles, and it’s what I recommend for anyone with ADHD.
  • Take ADHD seriously.
  • It’s easy to dismiss unseen disabilities, but ADHD can be incredibly disabling.
  • If it’s not clear by now, our invisible obstacles can keep us from reaching our goals, even when we try our hardest.
  • Even mild ADHD significantly impacts multiple aspects of our lives.

Chapter 7: How to Motivate Your Brain [03:30:00]

Introduction [03:30:00]

  • [”] Quote: “If we have our own why of life, we shall get along with almost any how.” - Friedrich Nietzsche.
  • [”] Quote: “I do what I feel like.” - Bart Simpson.
  • The chapter focuses on the internal battle between wanting to do something and the brain’s resistance.
  • Understanding why one should do something isn’t always enough to translate into motivation.
  • What matters is if the brain feels like doing it.

The ADHD Brain and Motivation

  • ADHD brains are not primarily motivated by importance [03:30:00].
  • ADHD brains find these tasks 👇🏼 to be painful:
    • lengthy tasks
    • repetitive tasks
    • boring tasks,
    • tedious tasks
  • Even with the motivation to accomplish a goal, working towards it can be difficult.
  • goals often come with multiple tasks that are tedious, leading to avoidance (aka procrastination).
  • Delay Aversion: The tendency to escape/avoid distress caused by delay. [03:30:29]
  • ADHD brains often prefer the immediate reward of fun activities over tedious tasks, even when caring about the overall goal [03:30:36].
  • ADHD brains are motivated by things that are urgent, new/novel, appropriately challenging, and of personal interest, i.e. stimulating [03:30:52].
  • This is linked to differences in the reward system of ADHD brains; they are “dopa-different” [03:31:02].
  • dopamine: A neurotransmitter that motivates and reinforces behavior [03:31:10].
    • When pleasurable activities happen, dopamine is released, signaling the brain to remember the activity
    • ADHD brains may not release anticipatory dopamine in the same way as neurotypical brains. [03:31:39]
    • Reuptake (reabsorption) of dopamine may occur before it reaches a receptor [03:31:46].
    • This prevents the brain from associating certain behaviors with positive outcomes.
  • Immediately rewarding activities “hijack” the brain due to dopamine release [03:32:04].
  • Dopamine levels also affect perception, emotions, and self-efficacy [03:32:28].
    • Low dopamine leads to lack of motivation, reduced pleasure, and fatigue [03:32:37].
    • Brains become understimulated, leading to procrastination, complicating tasks, and doing serious things in silly ways [03:32:45].

Intrinsic vs. Extrinsic Motivation

[03:33:16]

  • Intrinsic Motivation: Doing something because it is enjoyable and satisfying [03:33:22].
    • No external incentives needed.
    • Example: Eating cookies.
    • Examples that work for Jessica: Learning something new, spending time with animals, setting up new organization systems, cuddling up with a blanket and playing Nintendo Switch. [03:33:48]
  • Extrinsic Motivation: Doing something because of external consequences (rewards or punishments) [03:34:06].
    • Examples: Working hard on a talk because people will know if you don’t, making bread to have fresh bread, filing taxes to avoid penalties.
    • Extrinsic consequences often feel too far away to be motivating.
  • Temporal Discounting: Future rewards are perceived as less valuable than immediate ones [03:35:04].
    • ADHD brains have shorter time horizons, making future rewards even less motivating [03:35:22].
    • If a task is intrinsically rewarding, temporal discounting has less impact [03:35:48].
  • 😳 Extrinsic rewards can decrease intrinsic motivation [03:36:05].
  • ADHD individuals often rely on urgency, leading to last-minute crises and dopamine release, reinforcing the cycle [03:36:10].
  • Breaking the cycle requires immediate or exciting extrinsic rewards [03:36:41].

The Wall of Awful [03:37:15]

  • There is always motivation NOT to do the thing, which can be stronger [03:36:53].
  • Decisional Balance Worksheet: Can help understand what motivates you in either direction (available at howtoadhdbook.com) [03:37:05].
  • The emotions associated with a task are important [03:37:15].
  • Wall of Awful: (Brendan Mahan, ADHD Essentials) Emotional barrier built from past failures with a task [03:37:30].
    • The more past struggles, the higher the wall [03:37:37].
    • Requires motivation to climb the emotional wall in addition to the task itself [03:37:48].
    • Those with ADHD often have more and higher walls of awful due to increased experiences of failure, criticism, and rejection [03:38:08].
    • Common emotions: overwhelm, discouragement, hopelessness, Fear, confusion [03:38:14].
    • Weaker working memory can make it difficult to remember why you are doing something or how it will feel to complete the task, so all you see is the “wall of awful” [03:38:22].
  • Ways to deal with the Wall of Awful [03:38:53]:
    • Hulk Smash: Get angry enough to power through (can damage relationships) [03:38:58].
    • Put a Door in the Wall: Change the mood with music, TV, or a new location to distract yourself [03:39:10].
    • Climb the Wall: Do the emotional work of preparing to face the anxiety and gear up to do the thing [03:39:21].

Behavior Precedes Motivation

[03:39:58]

  • We don’t need motivation to take action; action can generate motivation [03:40:14].
  • Examples: Picking up a phone leads to checking apps; sitting on the couch leads to grabbing the remote; planning a road trip leads to making playlists.
  • Behavioral Activation: (Psychological term) Taking an action can lead to the motivation to continue. [03:40:43]
    • Example: Preparing for a bike ride (getting gear, checking tires) makes you more likely to actually go [03:40:48].
    • Can interrupt negative thought spirals [03:41:25].

It’s Not Entirely About Motivation [03:41:52]

  • Motivation is just one part of a “get stuff done” system (Dr. Ari Tuchman) [03:41:55].
  • Potential issues [03:42:14]:
    • Skill Gap: Not knowing how to do the thing or the steps involved [03:42:16].
    • Lack of Resources: Not having enough time, supplies, or energy [03:42:23].
    • Perfectionism: Anxiety preventing you from starting or getting stuck in mental loops [03:42:31].
    • Overly Optimistic Thinking (Positive Illusory Bias): Assuming you have enough time without checking [03:42:40].
    • Forgetfulness: ADHD-related memory issues [03:42:50].
    • Unrealistic Goal: Goal is unattainable or unsustainable [03:42:59].

The Toolbox: Strategies for Motivation [03:44:13]

  • ADHDers instinctively do many things to motivate their brains [03:44:15].
  • It’s unfortunate many internalize negative motivational techniques like berating themselves, which makes the wall of awful taller [03:44:22].
  • There are better ways [03:44:40].

1. Fill in the Motivational Planks [03:44:47]

  • Think of motivation as a bridge. ADHDers often have fewer “planks.”
  • Medication can help [03:45:08].
  • Other strategies [03:45:09]:
    • Add Urgency: Invite a guest over to clean, sign up for a class with a friend to exercise, set up a get-stuff-done meeting with a coworker, turn a marathon project into a series of mini-sprints [03:45:11].
    • Find the Right Level of Challenging: Adjust the difficulty to avoid boredom or frustration. “Write shitty first drafts” (Anne Lamott, “Bird by Bird”) [03:45:35].
    • Tie a Task to a Personal Interest: Incorporate interests into the task. Use D&D metaphors for a paper draft, turtle stickers to mark off tasks [03:46:09].
    • Add Novelty: Change location, tools, or people for boring tasks [03:46:43].
    • Resparklize: (Barbara Luther) When a working system stops, find a way to make it “shiny” again [03:46:56].

2. Reduce Friction and Grease the Wheels [03:48:05]

  • Remove barriers and add rewards [03:48:09].
    • Do What You Can Ahead of Time: Sleep in gym clothes, book classes in advance, make a checklist [03:48:28].
    • Remove Physical Obstacles and Other Barriers: Address sensory sensitivities (gloves for dishes, earplugs for noise, sunglasses for errands) [03:48:41].
    • Barrier Log: Track obstacles encountered during tasks to identify removable barriers [03:49:09].
    • Invest in Tools You Enjoy Using: Can make tasks more appealing and save money in the long run [03:49:29].
    • Tap into Your Why: Connect to the reason for doing the task. The Simpsons example, baby pictures cover the sign, “Do it for her” [03:49:54].
    • Ride the Wave: Take advantage of moments of motivation to tackle tasks [03:50:22].
    • Eat the Ice Cream First: (Jesse J. Anderson, “Extra Focus”) Do something enjoyable first to stay in a productive mode [03:50:32].

3. Add or Increase Accountability [03:51:39]

  • Shortens the distance between action and consequences [03:51:43].
  • Accountability alone isn’t enough; it can worsen anxiety in some cases [03:51:51].
  • If resources and skills are present, accountability can spur action [03:52:04].
    • Decide On What You’re Doing and Not Doing: Clarify priorities [03:52:16].
    • Find Productivity Partners: Body doubling, working in public [03:52:35].
    • Shorten the Feedback Loop: Ask for shorter deadlines or more frequent check-ins [03:52:55].
    • Make it a Competition: Gamify productivity, challenge a friend [03:53:20].

4. A Note on Procrastination [03:54:23]

  • procrastination is common for those with ADHD due to the urgency kick [03:54:26].
  • Active Procrastination vs. Passive Procrastination
  • Active Procrastination: Waiting until your brain kicks into gear, leading to similar performance to non-procrastinators.
  • Passive Procrastination: Head-in-the-sand avoidance, leading to negative outcomes [03:55:05].
  • Even active procrastination has costs, but the takeaway is that it is unrealistic to expect someone, especially someone with ADHD, not to procrastinate at all. But if you are going to, procrastinate mindfully.

5. Make Rewards More Salient [03:55:51]

  • Rewards need to be motivating to YOU [03:55:55].
    • Pick a Reward That is Meaningful to You: Choose something you don’t often allow yourself or related to your goals (fitness gear for working out, cozy sweaters for writing) [03:56:12].
    • Scale a Reward Strategically: Too big leads to inflation; too small isn’t motivating [03:56:37].
    • Make the Reward More Immediate: Immediate feedback, rewards as you go, pair something rewarding with the activity [03:57:09].
    • Tap into Your Excitement: Give yourself the reward for doing the thing [03:57:34].

6. Don’t Expect Yourself to Stick With Things [03:59:04]

  • Plan for variability in interest and motivation [03:59:08].
    • Cycle Through Hobbies, Jobs, and Interests: Switch when novelty wears off [03:59:36].
    • Be a Bumblebee: Carry lessons learned from one experience to the next [03:59:44].
    • Set a Date to Reevaluate: Commit for a set time, then decide if it’s worth continuing [04:00:10].

Coach A vs. Coach B [04:01:18]

  • Anecdote: Soccer goalie scenario illustrating two different coaching styles.
    • Coach A: Yelling, berating, focusing on mistakes.
    • Coach B: Providing constructive feedback, focusing on improvement.
  • We often treat ourselves like Coach A, especially when we make mistakes [04:02:56].
  • The trick is to notice when you’re berating yourself and ask what Coach B would say [04:04:16].
  • It’s important to adjust expectations, seek guidance, and focus on learning from mistakes [04:04:31].

Chapter 8: How to Remember Stuff. [04:05:40]

  • This chapter talks about what it’s like to have ADHD, The diagnosis has been very powerful for me already, because I now have such a wealth of knowledge about the nature of my struggles in life.
  • The solidarity of other ADHDers has probably been an even bigger help than meds, but don’t take my meds, they help too.
  • What I was really asking in retrospect was how do I meet these expectations my agent and manager have of me?
  • How do I be the person everyone is telling me I’m supposed to be?
  • She responded, “You don’t need to be smaller.

Toolbox for how to live with ADHD

  • This chapter also goes on about the challenges that a person faces having to deal with the hand that they were dealt.

The Takeaway’s:

  • It is important to remember that there are others going through the same issues, so to get in touch and try and help each other.

Chapter 9: How to Feel. [04:19:12]

  • This section discusses a plan about being aware and alert.
  • Be open to taking the medication and not taking the medication.
  • She ended up with disordered eating.

Chapter 10: how to people. [05:20:00]

  • It can be hard to explain that I’m not trying to make excuses for certain behavior.
  • I know that you need to put in the effort to make things work.
  • Learning the things that can help in having an ADHD will allow you to do the thing.
  • Don’t forget that my laptop’s battery was at 3% and I forgot my charger.
  • I knew how it would look.
  • The only way we can recognize and work with our challenges is by being honest about them, whether or not we think they’re a big enough deal.

How to use it in the Toolbox. [05:20:00]

  • Connect with others.
  • Connect with others.
  • Work with your brain, not against it.
  • Keep going.
  • She was given a permission to stop, Now I expected permission to quit.
  • What I got was permission to keep going.

Chapter 11: How to make ADHD Harder.

  • One strategy section of the document is when they have been very first set of tools.

Toolbox for 10,000 ft. [05:20:00]

  • Make sure they all are very well, from your comments.
  • Take 15 minutes, if even possible and if I’m doing anything differently here.

New Set of Tools to Add.

  • To this document, there are 5 strategies that I have used to use constantly.
  • And I have compiled them here for your convenience.

*Deny.

  • Apologize.
  • Beg.
  • Try to do better next time.
  • Try harder.
  • But as life got more complicated and there was more to do than just homework, the belief that I wasn’t trying hard enough morphed into a more insidious belief.
  • I’m not doing enough.
  • And so will come back to this later.

Chapter 12. And Final Chapter for Part 1 of the story.

  • Be careful when someone takes you to see what’s going on and what it means in the short term or on the long term.
  • I mean, it technically was in my head because that’s where your brain is.
  • I had no idea that all of the showing up late difficulty staying organized, irresponsible spending, and feeling like a hot mess were related to the condition I’d been diagnosed with 20 years ago.
  • As much as reading the research helped me understand my impairments and take them seriously, being around others with ADHD helped normalize them.
  • People are looking at me as if I were defective or weird.
  • There were so many others who were nodding along and saying, “Me too.”
  • I realized the extent to which we’re struggling because the behaviors they can see are only the tip of the iceberg.

Actionable Items and Tasks:

  • howtoadhdbook.com: [00:05:51, 00:58:07] Check for additional resources and information.
  • Explore Personal Toolbox Options: Experiment with the evidence-based strategies in the toolbox sections to find what works best for individual needs.
  • askjan.org: [00:57:53] Explore the Job Accommodation Network for workplace accommodations.
  • Implement Weekly Check-ins: Couples should consider scheduling regular check-ins to discuss relationship needs and address any imbalances.
  • Create “Doing” and “Not Doing” Lists: [00:34:51] Create a list of “doing” and “not doing” sticky notes to ensure you remember what to not do.
  • Create a “Not-to-do” List: Brainstorm a list of activities one should avoid due to ADHD problems.
  • Implement Augmentative and Alternative Communication systems. [00:15:07]

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