Talkin’ Trash: Targeting ADHD Treatment Goals

ADHD taking out the trash

 

You might be surprised. It’s not on the symptom list. It’s not on the “Top Ten ADHD Relationship Challenges.” But “not taking out the trash” is a common complaint among the partners of adults with ADHD.

It certainly was for me. Twenty years ago, before or just after diagnosis, my husband was one of those people. I did almost all the domestic tasks. Why couldn’t he do that one thing without me getting in his face?  It was only later that I learned from his mother:  “He used to call me the Queen of  Garbage! Just because I’d ask him to empty the trash.”

Therefore, people who know my husband only as a serious-minded scientist could hardly imagine what’s happening now: Come Tuesday trash-taking-out night, this is his happy rendition of Kool & the Gang’s Ladies Night.

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)

Ten years ago, neither my husband nor I could have imagined it, either.

These days, however, he’s actually happy to be taking out the garbage and recycling. That sure beats working himself up into a Klingon-warrior-inspired snit about it! Yes, it’s true.

Consider it just one of the miracles of medication. And a few attitudinal adjustments. Oh, and my boundaries.

ADHD taking out the trash

Get Specific with Medication Treatment Goals

His remarkable transformation came to mind today, in talking with some friends who have ADHD. I mentioned the importance of establishing specific 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.”  In other words, “taking out the trash” is a bugaboo for many adults with ADHD, too, not only their partners.

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.

I couldn’t have said it better myself, old friend.  That approach is the cornerstone of my first book’s chapter on medication (Is It You, Me, or Adult A.D.D.?)

You’ll find an excerpt as part of this post: The Tragic Truth of Adderall—or Madderall

It is also fundamental to the online training course I am producing at ADHD Success Training.

ADHD Treatment Targets—Beyond Taking Out The Trash

Another old friend with suspected ADHD understood immediately—and offered some great examples.

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. Until I can get a more expert evaluation, 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?

I’d love to hear your thoughts.

—Gina Pera
A version of this post appeared Jan. 11, 2013

11 thoughts on “Talkin’ Trash: Targeting ADHD Treatment Goals”

  1. Pingback: Talkin’ Trash: Evaluating Your ADHD Medication – ADHD Just Like Me

  2. This is a wonderful article! I was diagnosed and first treated for ADHD at the age of 9 and although I didn’t make my own goals/metrics they were still put in place (by my therapist, my parents, and my teachers). I was able to see an improvement in my impulsivity in speaking in class, my reading comprehension, and my ability to remember directions. But now that I have been treated with medication for so long (14 years) I forget to put these goals/metrics in place. If I do put them in place in my head, I can definitely see a major difference in how I function without my medication, and with my medication. And it makes me feel confident that medication is right for me and my ADHD. Although many people speak of how they no longer use their medication, I feel that in my daily life it genuinely makes me happier because I can get out of bed in the morning, because I can get to work on time, and because I can come home and not have to focus on doing chores and instead just do them. Thank you for posting this. It has definitely been an eye opener.

    1. Hi Morgan,

      I’m so glad you found the piece helpful. Thanks for writing.

      I think it must be so tricky for someone diagnosed and treated at age 9 to know what life would be like without Rx and supportive strategies. I’ve met many young adults who rejected the diagnosis and medication they’d been taking since they were children. Some really foundered, even after a few years still not accepting ADHD.

      Young people, diagnosed early, have such a different set of issues compared to the late-diagnosis folks.

      And yes, most of my friends with ADHD report being happier on medication, for a host of reasons. I’m glad that’s the case for you, and that you see the benefits.

      best,
      g

  3. When my daughter started taking meds at 11, I took it up as a scientific project. I am a scientist after all. I wanted to see evidence of the meds working or not, and I wanted to see evidence of the dose changes. Complicating matters was the fact that her dad and I are divorced and have the kids 50% each, so I had only half access to her behavior changes relative to the dose she was taking.

    So I put together a google form with all the questions that were used in her assessment, to make it easier for me to collect the data. This was the measurement tool. Then I designed the experiment: So I could separate the effects of different routines from the effects of medication on her behavior, I gave her medication first only on weekends, first on Saturday, then on Sunday. Then on school days. I run the questionnaire three times a day on weekends and twice on weekdays, once immediately after school and once at bedtime.

    This allowed me to advocate with the doctor to have the dose changed until we saw the effect we needed. I have been thinking about creating an app for kids to use that would allow parents and doctors to collect data like this. I would love to hear what you think about it Gina.

    1. Hi Isabel,

      What do I think? I think you’re brilliant! 🙂

      As for designing an app along similar lines, that’s out of my “wheelhouse,” as they say.

      I know that there are already some systems available, such as Definipoint. I have a free trial to it, signed up, but have yet to wade through how it works:

      https://www.attentionpoint.com/main/index.php?

      best,
      g

  4. Hi Gina,
    I am having a daughter who is 11 years old and having ADHD.
    She is not as much brilliant in studies and always clears her exams with poor marks.
    I am really worried about her future, will she be able to make her career as a doctor because all she wants to be a doctor but that’s need sharp mind.

    1. Hi Jeena,

      She is 11, with much opportunity to change her mind about career goals.

      Sometimes having a big goal and being passionate about it can help child focus on the more tedious aspects of education.

      But if she has ADHD and is not receiving treatment for it, she might have a harder-than-necessary time in reaching any goal.

      You don’t mention if she is receiving any treatment. Also, if you or her father has ADHD, you want to make sure it is being “owned” and tended to so you can better help your daughter.

      Good luck,
      g

    2. Veronica Knaflic

      Hello there, My son is 16, he has ADHD just like I do. Lucky him, his Dad and I saw ADHD on him early in his life and have been using medication only recently. Before he needed only some handy medication we found in Amazon worked very well for children, called ‘Attentive Child’ . It stop working after 7th grade and we saw not only a personality transformation but a imperative need for medication. He is in his 6th month of medication, even thought he says he doesn’t see it working we could see the changes right away. He has requested our Doctor to up his medication for this reason, I believe we can start a whole new trend with things teenagers experience with ADHD. The issue with the garbage is not only for adults, my son hates it too but I have noticed that if I bug him with it he will not respond to it. He responds better when the garbage gets in his way like the back door when he finds it before getting into the house, this way he doesn’t even make a big deal out of it. Another thing is having patience with him I have to keep constantly reminding myself I was just like him growing up.

    3. Hi Veronica,

      Has he called you the Queen of Garbage — as my husband called his mother when he was growing up? 🙂

      Patience is a virtue. 🙂 But sometimes showing patience is not the friend of the child (or adult) with ADHD.

      It’s better to develop strategies and work on implementing them. And to, of course, maximize medication.

      Easier said than done, I know.

      But it is important that he identifies the changes that medication can bring, because he should know how it is benefiting him and not just his parents. 🙂

      But he might need some help in drawing his attention to it. Ideally, the physician helps with that. But many don’t know how or don’t have the time.

      Many males with ADHD, in particular, don’t think the medication is “working” unless they feel a “buzz.” That’s one reason why so many get in trouble with Adderall — because it will create that buzz.

      So, the more you can link what he considers his challenges to how the medication is lessening those challenges, the better.

      Good luck and thanks for writing,
      g

    1. 🙂 People tell him that quite a bit, GloryB. 😉

      I’m lucky to have him, too, though I must admit, he lucked out when it came to having a wife who is both logical and empathic.

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