Talkin’ Trash: Targeting ADHD Challenges

Oh yes it’s garbage night
And the feeling’s right
Oh yes it’s garbage night
Oh what a night (oh what a night)

People who know my husband only as a serious-minded scientist could hardly imagine, come Tuesday trash-taking-out night, his jaunty rendition of Kool & the Gang’s Ladies Night.

Ten years ago, neither my husband nor I could have imagined it, either. He’s actually happy to be taking out the garbage and recycling instead of working himself up into a Klingon-warrior-inspired snit about it? Yes, it’s true. Just one of the miracles of medication. And a few attitudinal adjustments.

I was reminded of that remarkable transformation today. In talking with some adults who have ADHD, I mentioned the importance of establishing treatment targets before starting to take medication; otherwise, how will you know if it’s working? Meg agreed: “The first big clue I had that my meds were working was when, instead of thinking about how much I hated taking out the trash and recycling, I just took out the trash and recycling.”  A woman after my husband’s heart!

Recently, I’ve reconnected with an old friend newly diagnosed with ADHD. In an e-mail exchange, I offered some advice on getting the most of medication, including the importance of establishing subjective measures.  You can’t just sit around, asking yourself if you “feel it working.” Of course some people do describe feeling a “cognitive fog lifting”  or more consistent energy.  More reliably, though, it’s collecting hard data that will help you to optimize your medication dosage and timing.

My friend understood immediately, and offered some great examples. She is a massage therapist, and her “treatment targets” specifically apply to her, but they might help you establish your own targets.

Dear Gina,

You make great good sense about assessing non-visceral clues for the medication working. I really did not like that speedy feeling. And it doesn’t necessarily create better functionality. I have developed a whole list of diagnostic clues for myself. For example:

• How long to get ready in the morning?
• When I’m, “ready,” have I brushed my teeth, put on make-up, made the bed, made a lunch? Or did I just decide to leave because I’m 20 min. late?
• Do I have my purse with me? My water? Anything else I was supposed to bring, like maybe sheets and lotion?
• How many days do the clean sheets sit in a pile in the living room before they get folded and put away? Or do I finally just grab the whole pile and put it in the Jeep and take it to work with me?
• Has it been more than 3 days since I left the water running, the burner on, or the lights or the heater on?
• Did I remember to turn the heater or the lights on when they are supposed to be on?
• If I’m around the house all day, how many little tasks do I come across that are started but not completed?
• When I’m done cleaning up, could anyone tell?

How about you or your loved one with ADHD? Before starting treatment for ADHD, were there established goals or metrics?  How did you do it?