Areas › Focus, starting, and ADHD
Focus, starting, and ADHD
Most advice about focus is written for a brain that starts easily. This area is not. It covers what ADHD actually is, how to make a start when starting is the hard part, how to bring a future consequence close enough to feel, and how to stop paying for it in shame.
What works for this
Implementation intentions
Putting things off is mood repair rather than laziness: delay removes the bad feeling straight away and the cost lands later. So the move is not more willpower, it is a plan specific enough to run without a decision.
One move, today
Write one sentence: when it is [time] and I am at [place], I will [the first small action]. Naming when and where is the part the evidence supports.
What matches
19 practicesPill swallowing can be taught in a few short sessions with sweets. Start with the tiniest ones, give two to eat for every one swallowed whole, and work up in size across a week.
Keep each session short and cheerful and stop before anyone is upset, since one frightening attempt can set the whole thing back weeks. For capsules,…
Before you explain anything about medication, ask what the person already believes about it. You cannot correct a worry that has never been said out loud.
Most people arrive carrying something: a cousin who could not sleep, a headline, a parent with a strong view. Lead with your own information and you…
In practice the non-stimulants turn up more often as an addition than on their own. A stimulant in the morning with guanfacine alongside it is a common shape.
The two act at different points of the same circuit, so they tend to complement rather than repeat each other, and the blood pressure effect of one…
A small short-acting dose in the afternoon, on top of the long-acting one, is ordinary practice rather than a special case. Homework and the evening drive often fall outside what the morning dose still reaches.
The hours when you most need to hold back are frequently the hours the medicine has stopped covering. Raising the morning dose to solve an early…
Skipping weekends, holidays and summers is a common suggestion and mostly it is the wrong call. The difficulty does not take a holiday when school does.
Unstructured time asks more of planning and self-regulation rather than less: whole days to fill, everyone at home, no timetable holding the shape of…
Methylphenidate and amphetamine are not two names for the same thing. One mainly blocks dopamine from being taken back up, and the other does that and pushes more of it out as well.
That extra step is why the amphetamines tend to produce somewhat larger average effects, and why somebody who got nothing from one can do well on the…
Plenty of children on a stimulant are taking something else as well, most often an antidepressant. That second medicine is usually there for a second problem rather than for the attention itself.
It is a useful lens when a regimen has grown complicated. Ask what each item is for, and the list generally resolves into a treatment for the…
To find out whether treatment is helping, ask the people who live with the person. One parent who stopped her medication for a family holiday remembered a lovely trip, while her children remembered running it.
Two teenagers had packed for her, fetched what she forgot, and kept an eye on the airport clock. She had no idea any of it happened. There is no…
The old argument about medication against behaviour therapy was set down years ago. The useful question now is what each one covers.
They work by different routes and they reach different hours of the day, so putting them in a single contest was never going to tell anyone much.…
Adding psychosocial work to medication buys something extra, and less than people hope. The extra tends to arrive in the places medication was never going to reach.
Homework routines, the temperature of arguments at home, how a teacher speaks to a child, the hours after a dose has worn off: that is where the…
Doing the behavioural work alongside a medicine can mean managing on less of it. That matters most for the side effects that follow the size of the dose.
Appetite, sleep and irritability all tend to scale with how much is being taken. Where part of the load is carried by routines, by support at school,…
Stopping medication rises sharply in the early teenage years. If that is where you are, it helps to know this is the usual pattern rather than a sign that something has gone wrong with your child.
The pull is understandable: wanting to be in charge of your own body, hating being the one who is different, and a parent no longer standing over the…
Blood pressure on a stimulant is an individual matter. For most people it is a non-event, and where it does rise the answer is often a different stimulant rather than none at all.
No blood test or cheek swab will tell you in advance which one suits you. Finding out means trying, measuring and being willing to change, which is…
Headsets have become cheap enough to sit in an ordinary consulting room, and the use with the best backing is graded exposure. You can set the intensity exactly and repeat it as often as the person needs.
The value is in the control. A feared situation can be dialled up in small steps, run again the moment it stops being frightening, and ended without…
With some sensory routines, the part doing the work may be a parent's steady hands and full attention rather than the technique itself. Worth knowing, because contact carries into the rest of the day and a protocol does not.
Views differ on this and the research has not sorted it out. What follows practically is that a family who cannot keep the exact routine going has…
A lot of what people now know about ADHD came from a video. Some of it is genuinely good, some of it is not, and asking someone what they have been watching is a fair question to open with.
Creators who live with ADHD have done real good here. They have made people feel recognised and made asking for help less frightening, and some…
Long acting does not automatically suit everybody. Some people genuinely do better on shorter doses, and it is worth saying so rather than assuming the newer option must be right.
There is a folk belief that a person's own chemistry takes over in the afternoon once the medicine wears off, and the research does not support it.…
Managing the ADHD is not the goal. Being happy together is the goal, and the ADHD work is only worth doing to the extent that it gets you there.
Keeping that order straight changes the atmosphere of the whole effort. A partner who has spent years being a project stops being one. Requests stop…
Paying someone to help sort the house will not mend the marriage. It will remove one of the things you fight about most weeks, and that counts for more than it sounds.
Nobody should pretend this reaches anything deep. The point is arithmetic. A couple has a certain number of rows in them, and if the living room is…