Focus, starting, and ADHD

Sometimes both roads carry a cost and neither will feel good. Accept that first, then choose, rather than searching for the option that comes without a sting.

A lot of long deliberation is really a search for the version that leaves nobody upset and nothing lost. When that version does not exist, the search…

An app can tell you what needs doing. It cannot make you want to do it. That gap is why the next one will disappoint you too.

Reminders, alarms and lists are genuinely good at the first job, so it is easy to assume a better one will finish the second. It will not, because…

Choosing the app, picking the colours, setting up the tags: that is the task avoiding you. It is interesting, it feels like preparation, and by bedtime nothing has been done.

New systems are enjoyable in a way the actual work never is, which is exactly why the evening goes that way. A useful test is whether anything on…

When something does not get written down, go back to that exact moment with curiosity rather than a telling off. What was in your hands, where were you, what did you tell yourself?

The useful information is all in the specifics: the request came in the corridor, the phone was in your other hand, you were already late. That is a…

We all keep a few small stories that let us take the easier option in the moment. Not lies to other people, just the ones we tell ourselves and half believe.

They are not a sign of a bad character. Everybody has a set, and what you have been through shapes which ones you specialise in. The reason to know…

You are allowed to decide not to write things down. What you cannot do is choose that and then be upset with yourself when you forget.

Straddling is the expensive bit: taking the easy option in the moment and the guilt afterwards. Pick one honestly. Either the note gets written, or…

Some tasks are avoided because nobody has said what they want. Not knowing what good looks like is its own reason to keep walking past something.

An unclear job asks you to do two things at once: work out what it is, then do it. On top of that sits the worry of getting it wrong in a way you…

An avoided task charges you rent even on the days nothing goes wrong. The low hum of hoping nobody asks is part of what it costs.

When we weigh up leaving something undone, we usually count only the visible consequences, the letter that might arrive or the person who might…

A task you dislike needs a time and a place, not a place on the list. Tuesday at ten, at the kitchen table, is a plan. Soon is not.

Left in open competition, the dull job loses to everything more urgent and everything more interesting, every single day, and that is not a fault in…

Put the thing you are avoiding early in the day. Anything you place late gets pushed out by whatever the day turns into.

Early has two advantages at once. It is less likely to be shunted, because the day has not yet piled up behind it, and if it does slip it only slips…

Email is the easiest place to hide. It answers back, it never runs out, and by five o'clock it feels like you worked.

What makes it such a good stand-in for real work is that the rewards come in small unpredictable bursts and almost none of it asks much of you. Your…

Turn a vague plan into an if-then: when I sit down after lunch, I will open the one file.

Deciding in advance exactly when and where you will start removes the moment of friction where you usually stall.

An ADHD diagnosis usually arrives with two extra words attached: which presentation it is, and how severe. Both are descriptions of what gets in your way, not a grade you were awarded.

Inattentive, hyperactive and impulsive, or the two together, and then mild, moderate or severe. Mild means you met the threshold and the effect on…

The age by which symptoms have to have shown up is a number people agreed on, not a line in nature. It moved from seven to twelve when the manual was revised.

That matters if you are an adult wondering whether you would even qualify. The old cut-off was itself a compromise between studies pointing in…

Teenage memories of this often come with a sting: the year you worked out how much longer everything took you than it seemed to take everybody else.

That is usually why adolescence is the period people can describe in detail. The work got harder, the scaffolding of primary school fell away, and…

Hyperactivity and impulsiveness almost never turn up alone. When restlessness appears with no attention difficulty beside it, that is a reason to ask what else might be going on.

In practice the two run together, and over the years the visible restlessness tends to settle while the attention side stays. So a picture that is…

You do not need clinical language at an assessment. Some of the wording in the manual came straight from how families described it in the first place.

Phrases about being permanently on the go are in there because people kept saying them. So use yours: that your head is like a browser with forty…

The diagnostic manual is a document people sat in rooms and argued over. That is no reason to dismiss it, and it is a good reason not to treat it as the last word on you.

Committees weigh how reliably clinicians can agree on a criterion, what the field trials show, what a particular wording will do out in the world.…

There is a difference between low mood you have carried all your life and low mood that grew out of years of working twice as hard for half the result. Both are real, and they need treating in a different order.

If the second describes you, the picture often lifts a fair way once the attention difficulties are being managed and the daily experience of falling…

The checklists were built around the loud version of this, and girls are more often the quiet version. If she is struggling and nobody has ever suggested an assessment, that is worth pressing on.

Defiance in girls can look like refusal, withdrawal or a long-running argument about friendships rather than the disruption a teacher would report.…

Not all distraction comes from outside. Some of it is a thought that will not leave, circling while you read the same paragraph four times.

That difference matters at an assessment. Being pulled away by everything in the room, and being held in place by an intrusive thought you cannot put…

Most autistic people also meet the criteria for ADHD. The other direction is much thinner: only a small minority of people with ADHD meet the criteria for autism.

That is mostly arithmetic rather than mystery. ADHD is the more common of the two, so one overlap looks large from one side and small from the other.…

Autism and ADHD share some surface features and are still two different things. The social difficulty in each arrives by a different road.

With ADHD it tends to be impulsiveness and missing what was going on: the interruption, the thing said too fast, the friend never rung back. With…

Eating that runs away from you, and eating you cannot stop once it has started, turn up alongside ADHD more than people expect. Usually it is doing a job rather than proving a weakness.

The pattern leans towards bingeing rather than restricting, which fits: it belongs with the difficulty of stopping something already in motion. Often…

Trouble with eating, and with how your body looks, gets missed far more often in men. The questionnaires and the expectations behind them were built around women.

In men it runs more towards size and muscle than towards thinness, and towards fixing on one part of the body that everybody else says looks…

Very sweet, very salty, very fatty food acts on the reward system in a way that has more in common with a drug than with dinner. Reaching for it when you are flat is self-medication, not greed.

Knowing that changes what you do about it. Counting calories and resolving to try harder both aim at willpower, which was never the mechanism in the…

With gambling machines the pull may be the lights and the noise as much as the chance of winning. That changes what you actually need to stay away from.

If the sensory buzz is doing the work, the triggers are not only the betting shop. They are the phone games built with the same flashing and chiming,…

A reward that comes every time is easy to walk away from. A reward that turns up unpredictably is the one you cannot put down, and that is exactly how your phone is built.

Sometimes there is something good in the notifications and usually there is not, and it is that uncertainty which keeps you checking. Willpower is…

When you read that some proportion of people with ADHD have a particular problem, the number tells you nothing until you know the figure for everybody else.

Twenty percent sounds alarming until you learn what the rate is in the general population. What matters is the multiple, how many times more likely,…

Hypervigilance after trauma and ADHD scanning look much alike from outside. Often the honest answer is that both are present, and the real question is how much of each.

Watching that comes from threat is aimed at something and tends to switch on in particular situations. ADHD distraction is not fussy about where it…

Damage to the front of the brain can produce something that looks a great deal like ADHD: poor impulse control, blunted judgement, a person their family says has changed.

The nineteenth century railway worker who survived an iron rod through the frontal lobes is the standard illustration, and what altered in him was…

Not every bout of eating too much belongs to an eating disorder. Ask whether how the body looks is part of it, because that is where the two paths separate.

When bingeing comes out of ADHD it is often boredom, or the food simply being there with nothing stepping in to stop it, and the person is not…

Check the licensing before assuming you cannot afford a good instrument. Some come with permission to photocopy once you have bought the manual.

That detail matters most to the clinicians least likely to have a budget, which usually means the services seeing the families with fewest options. A…

There is more than one decent instrument, and which you use often comes down to what you were trained on. If you have never used one, say so rather than having a view about it.

Several rating scales are in wide circulation for children and for adults, validated by different groups for slightly different purposes. Picking one…

Home DNA tests turn up relatives nobody expected. If someone is thinking of taking one to fill in a blank family history, it is worth saying out loud that it may hand them more than they asked for.

People find half siblings. Sometimes they find that the story they were told about their birth was not the story. That is a great deal to receive by…

Ask for the old school reports every time. Some people arrive with a folder of every one they ever had, and you cannot tell in advance which people those are.

It is easy to assume that a parent who is disorganised will not have kept anything, and that assumption quietly costs you evidence. Teacher comments…

When you need a date, hand people events rather than months. Was that before or after the holiday? Same year as the move?

Asking whether something happened between October and January invites a guess. Asking whether it was before or after a wedding, a house move or a…

Ask for a number first, then go hunting for exceptions. How is today on a scale of one to ten, and when was it last higher than that?

An assessment can turn into an hour of everything that is wrong, which leaves a person flatter than when they arrived. Exception questions do the…

Find out what they have tried before that did not work. It saves everybody from a plan that failed this person two years ago.

Most people arriving for an assessment have been trying things for years: apps, alarms, lists, an early night, a course somebody recommended.…

The manual now asks for signs by age twelve rather than age seven, and it added wording that fits adult life, including restlessness felt on the inside.

The older cut-off quietly excluded a familiar group: bright children, or well supported ones, who managed until the demands rose and only visibly…