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About 4 per cent of adults have ADHD, according to Dr. Tim Bilkey, but many do not realize they do. (Jackie Vaz)
About 4 per cent of adults have ADHD, according to Dr. Tim Bilkey, but many do not realize they do. (Jackie Vaz)

A doctor’s 4 tips for managing adult ADHD (that anyone can use) Add to ...

You’re chronically late. You have trouble staying on task. You constantly feel like you’re not achieving your potential. You may be suffering from “FAST MINDS.”

FAST MINDS is an acronym for a series of traits that doctors Tim Bilkey and Craig Surman identify in about 4 per cent of adults: forgetful, achieving below potential, stuck in a rut, time-challenged, motivationally challenged, impulsive, novelty-seeking, distractible and scattered.

While most of us exhibit some of these traits from time to time, Bilkey, a Canadian psychiatrist, and Surman, an assistant professor of psychiatry at Harvard Medical School, say that having multiple and consistent symptoms could be a sign of adult attention deficit hyperactivity disorder, or ADHD.

While many individuals who are diagnosed with ADHD as children eventually “outgrow” it, around 60 per cent continue to have the disorder as adults, Bilkey says. Many more adults may not realize they have ADHD, which can be inherited, until their own children are diagnosed.

In their new book, FAST MINDS: How to Thrive if You Have ADHD (Or Think You Might), Bilkey and Surman and their co-author, journalist Karen Weintraub, offer strategies to help not only adults with ADHD, but anyone who recognizes they have certain FAST MINDS traits.

Speaking from his office in Barrie, Ont., Bilkey explained some of these strategies to The Globe:

Making tasks matter

What it means: “It is easier for people to stay engaged if they’re doing things that matter to them. People with ADHD have trouble delaying gratification and sort of keeping an eye on the prize. So I think you have to define your goals and it’s also important to be accountable and track how you’re doing.”

How to do it: “Relying on external accountability, using reminders or looking to other people for support can help. For example, there’s a woman who, when she’s working on a difficult project like writing a book, will e-mail one of her pals who also has ADHD to say, ‘I’m working on chapter one, and I’ll e-mail you later when I’ve finished it.’ So she uses that kind of reciprocal relationship for accountability. But everybody will be different when it comes to finding out what will help them develop better habits and better routines.”

Recognizing critical moments

What it means: “The critical moment is what people say to themselves just before they don’t do something they should, like tackling a pile of bills. It’s recognizing that, ‘Oh no, if I don’t do this task now, it’s likely that I won’t do it.’

“Or when it comes to impulsivity, it’s recognizing that when you see something you like and you want to buy it very much, you can push the pause button and say, ‘Wait a minute, if I really want it, I can come back tomorrow and get it.’”

How to do it: “The issue with adult ADHD is that if people have lived with it all their lives, many will just assume that their symptoms are a personality trait – that that’s just the way they are. They’re more oblivious to their habits. I refer to it as the ‘garlic effect’; people who have eaten garlic aren’t so aware of the impact on their lives and others. That is why we ask people about how their partners react to their habits or whether certain traits create stress in their relationships with other people, so they get a better recognition of the impact of their actions.”



Eliminating internal and external distractions

What it is: “With internal distractibility, university students who have untreated ADHD may be sitting in a lecture that’s not particularly engaging and they’ll drift away. They’ll say their mind wanders, they start to daydream. That’s a typical scenario. They could also be distracted by other thoughts and feelings.

“People with adult ADHD often have automatic negative thoughts, so instead of listening, they’ll sit there and think, ‘What if I flunk this course? Then I won’t get into the program I want.’ There’s also external distractions, like all the conversations and action around them when they’re trying to listen to that lecture.”

How to do it: “When it comes to external distractions, we often suggest that people have a clean environment, like a clean desk with not too much clutter. If there’s a pile of clutter and there’s all this stuff around, people get stuck. Another tactic: I had a university student who would quietly play white-noise-type music on his iPod during lectures to block out everything else so he could concentrate on the speaker.

“With internal distractions, because automatic negative thoughts are so common, what people with ADHD tend to do is they’ll take a compliment and they’ll turn it around on themselves and say, ‘Well, if I’m such a smart guy, how come I’m in this situation?’ So we suggest keeping thought records, documenting all the negative things you say to yourself, recognizing patterns and offering more rational explanations. So it’s asking yourself, ‘What would my pals say? What would my girlfriend say?’ and getting that balance. It helps clear the slate in terms of all that negativity.”



Rewarding yourself frequently

What it means:“We know there are differences in the reward centres of the brains of people who have ADHD. People with adult ADHD seem to have two speeds: 0 and 100 miles an hour. We suggest being aware of when you’re more likely to not continue with a project – we call that a ‘default path’ – and then giving yourself short-term rewards.”

How it works: “It’s breaking tasks down into definable parts. Instead of saying, ‘Tonight I have to write my paper so I’ll stay up all night until it gets done,’ it’s saying, ‘Well, I’ll research the first chapter and then I get to call my girlfriend, or I get to make a pizza.’ That can be very gratifying.”

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