What Type of Friend Are You? How ADHD Influences Friendships

What Type of Friend Are You? How ADHD Influences Friendships

Whether you collect new friends easily or lean on a few, long-term friendships dating back to kindergarten, there’s no wrong way to build relationships. This is true especially for people with ADHD, who often report that their symptoms complicate, challenge, and color friendships. The ones that work are the ones that accept and celebrate their ADHD.

What Type of Friend Are You?

“I fall in the Selectively Acquisitive Friendship Style category; I am very careful and particular about who I label a ‘friend.’ Anybody who I don’t refer to as a friend is my ‘acquaintance.’ My ex used to laugh at this distinction, but it’s super important because it helps me decide how much time I spend with these people, and if I make an emotional investment in them. Yes, I help everyone when in need, but I will do it much more for my designated ‘friends.’” — BAT

“I’ve always migrated toward long-term friendships that can tolerate long gaps in communication, as well as friendships where we can talk for hours about things we’ve read or learned, or be just as happy sitting on the same couch each immersed in our own hyperfocuses.” — Anonymous

“My husband says I’m like a semi-truck with an engine that’s too small. I genuinely want to be friends with everyone, but I have difficulty keeping up with the logistics of maintaining friendships (due to my executive function weaknesses and anxiety). So, I have a long to-do list of people I need to text, call, email, etc.” — Anonymous

“Since I graduated from college, I have had trouble establishing friendships. I feel anxious about reaching out to potential friends outside of work or other organized activities; I worry that they will be too busy or uninterested in doing things with me. I once invited a co-worker and her husband over for dinner with me and my family. She accepted the invitation, but a few days later told me, ‘My life is too busy — I don’t have time for any more friends.’ That really stung!” — Anonymous

“I prefer intimate hangouts because boisterous get-togethers often overwhelm me. I tend to focus on a few long-term friendships, but being a military spouse means I have to be able to pick up new friends easily whenever we move.” — Anonymous

“I typically gravitate toward people who excite me. I’m also a bit co-dependent and find I search for long-term, meaningful relationships.” — Anonymous

“I’m extremely nervous around quiet people. I start to do nervous chatter, and they don’t reciprocate so I move on. I dread being around them! But I also get overstimulated in noisy environments. I like intimate hangouts with a few good friends who like to talk. I was the one who got moved in elementary school for talking too much. But then I’d make friends with the new table.” — Anonymous

“I would say I’m an ambivert. I can be really social for a few hours and then I’m socially spent. I have lots of lifelong friendships but also make spontaneous new friendships. However, I often don’t have the energy to maintain new relationships.” — Anonymous

“When I’m in good social form, I love talking with everyone. I’m a little afraid to put all of my friends together in one room because I’m not sure how well they’d get along. I love my ADHD friends because they are a less judgmental bunch. If I’m late or crazy-spontaneous or any of the other quirks that come with the territory, they get it. And they like me, for me. Recently, I realized that I’m a social chameleon who adapts to the people around me, hiding the ‘unacceptable’ parts of myself depending on the company. As a result, I’m not sure who the unvarnished, unmasked me is — I’d like to find that person. It probably would be less stressful and not so freaking isolating.” — Anonymous

“I really need friends who don’t need me to call every day or plan things regularly, but when we get together there seems like no gap in our friendship. We trust that we are always there for each other. My best friend and I could talk forever (we’re both time blind), and the subject can change mid-sentence or at least every two minutes. I am sure she has undiagnosed ADHD; we understand each other far too well!” — Glenda

How to Break the Exhausting Habit of Revenge Bedtime Procrastination

How to Break the Exhausting Habit of Revenge Bedtime Procrastination

What Is Revenge Bedtime Procrastination?

Revenge bedtime procrastination is the act of deliberately putting off sleep in favor of leisure activities — binging Netflix or scrolling TikTok, for example — that provide short-term enjoyment but few long-term life benefits. Revenge bedtime procrastination is especially likely when busy schedules and daily responsibilities prevent the enjoyment of “me time” earlier in the day. (The idea is that you’re exacting “revenge” on all of life’s stressors and obligations by delaying sleep for leisure and entertainment.)

Of course, sacrificing sleep carries its fair share of consequences — namely exhaustion, poor productivity, health ramifications, and shame. In short, revenge bedtime procrastination is an unhealthy habit – and one that may be more common and troublesome for adults with attention deficit hyperactivity disorder (ADHD or ADD).

Revenge Bedtime Procrastination: Origins, Signs, and Impact

Revenge bedtime procrastination is the approximate English translation of a Chinese expression for delaying sleep to regain freedom lost during the day. The term took off during the pandemic, as sleep problems and psychological distress collectively skyrocketed.1

Anyone can engage in revenge bedtime procrastination, but people with high-stress, busy lives and/or poor time-management skills might be more likely to put off sleep for personal time. That demographic is heavily weighted toward women, who as a group lost significant personal time during the pandemic as they took on a greater share of parenting and housework compared to men.2

Though a relatively new term, bedtime procrastination is not a new concept to researchers.3 The behavior – defined as going to bed late, absent of external reasons, and with an understanding that the delay will result in negative consequences – is conceptualized as a self-regulation problem.4 (You know what else is often described as a self-regulation problem? Yep, ADHD.)

Proper sleep is vital for functioning and overall health. That’s why inadequate sleep and poor sleep hygiene can contribute to a list of problems including:5

  • impaired cognitive functioning (memory, focus, concentration)
  • weakened immune system
  • dysregulated metabolism
  • anxiety and other mood disorders
  • increased mortality6

Revenge Bedtime Procrastination and ADHD

Why might individuals with ADHD be particularly susceptible to revenge bedtime procrastination?

Sleep Problems and ADHD

Research shows that individuals with ADHD experience problems with virtually all aspects of sleep, including:

  • difficulty falling and staying asleep7
  • daytime sleepiness3
  • Poor sleep quality and difficulty waking up8

ADHD is also associated with “increased eveningness” (preference for a later bedtime).9

Do Mindfulness Interventions Improve Obesity Rates in Children and Adolescents: A Review of the Evidence

Do Mindfulness Interventions Improve Obesity Rates in Children and Adolescents

Mindfulness interventions have shown promise in improving self-regulation, depression, anxiety, and stress levels across all ages. Obesity rates in children are rising worldwide. It has been postulated that through improvements in self-regulation with mindfulness interventions, obesity rates can be improved in children and adolescents. In this review, we attempt to explain how mindfulness interventions may impact obesity rates and obesity-related complications and give the current state of evidence for the following mindfulness interventions: Mindful Eating, Mindfulness-Based Stress Reduction, Yoga, Spirituality, and Dialectical Behavior Therapy.

Over the last 20 years, childhood obesity has become a major public health concern in the United States. According to the most recent data from the Center for Disease Control and Prevention (CDC) in 2015–2016, 18.5% of American youth between the ages of 2 and 19 were classified as being obese using a body mass index (BMI) threshold >95% for age.1

The rate of obesity increases with age in children. Children between the ages of 2 and 5 have an obesity rate of 13.9% as compared to 20.6% in children between the ages of 12 and 19. In addition, obesity has some ethnic predispositions, with obesity rates being most prevalent among Hispanic and Non-Hispanic Black children with no significant difference between the sexes.1

Obesity begins in childhood due to a combination of genetic, social, physical, and psychological factors.2 As children with obesity age, they often develop obesity-related comorbidities including insulin resistance, early onset diabetes mellitus (DM), hypertension, hyperlipidemia, depression, and sleep apnea.3 These medical conditions often persist into childbearing years and adulthood.4 Pregnancies of women with obesity are more likely to have perinatal complications or be stillborn.5 Infants born to mothers with obesity have increased rates of neuropsychiatric disorders including autism, attention deficit hyperactivity disorder (ADHD), anxiety, depression, eating disorders,6 and adult obesity.7 This circular pattern perpetuates, increasing obesity rates in all ages.

With the increase in families with obesity, pediatric medical providers are consistently charged with finding evidence-based treatments. One area of interest is the use of mindfulness interventions to modulate eating behaviors.

According to Jon Kabat-Zinn, mindfulness is a psychological process of purposely bringing one’s attention to experiences occurring in the present moment without judgment.8 Mindfulness activities have been effective in altering human behavior to improve health promoting behaviors.9–11 In addition, mindfulness activities have consistently shown improvements in levels of stress and anxiety and increased stress has been associated with weight gain.9–12 For these reasons, it seems that mindfulness activities may provide value as a treatment option for patients with obesity.

Human Eating Behavior

To further understand how mindfulness may affect obesity, it seems paramount to understand the psychology of human eating behavior. Human eating behaviors are based on the existence of personal and psychological constraints that operate in addition to food availability. Figure 1 was created by Ulijaszek et al13 based on the initial work of Mela et al,14 and describes a mechanism where human body-weight homeostasis may be maintained or lost based on different factors including food availability, energy density of the diet, genetic, psychological, physiological, behavioral and cultural factors.

Through this theory of the psychological contribution of weight gain, it would be a logical deduction that being more mindful of emotions and how emotions affect eating behaviors would allow one to control what he or she eats. As a consequence, there may be decreased consumption of high calorie foods and increased consumption of healthier, low-calorie foods. With time, this change in food preference may lead to weight control or weight loss and decreased amounts of obesity.

Figure 1. This flow chart explains that when one is exposed to high fat, sweet, or highly processed foods combined with learned feeding behaviors, preferences for these foods may be established. The combination these preferences, Increased availability of unhealthy foods, loss of dietary control from social and cultural eating patterns, and emotional eating or eating environments, predisposes individuals to over-consumption of energy dense foods. This in turn leads to overeating, positive energy balance, and weight gain. Low physical activity and genetic predisposition may negatively impact the picture further.

What is Emotional Dysregulation?

What is Emotional Dysregulation?

Emotional dysregulation refers to difficulty in managing emotions or in keeping them in check. These may also be thought of as mood swings or labile moods. It can involve experiencing intense emotions such as sadness, irritability, frustration, or anger that are comparatively more heightened than expected, relative to the situation that triggered them.

What is emotional dysregulation?

Emotion dysregulation involves difficulties with negative affective states e.g., sadness and anger.

Emotional dysregulation might affect children or adults. Adolescents may be particularly at risk due to this developmental period in a person’s life being recognizably a time of increased stress due to puberty and peer context. Although it is a common perception that children learn to manage their emotions as they grow up, for some effectively managing emotions continues to be problematic well into adulthood.

Those with emotional dysregulation might not easily recognize their own emotions and can become confused or guilty about emotions experienced such that behavior is not readily controlled and decision making becomes a challenge.

Experiencing intense emotions can lead to situations in which a sufferer is unable to calm down easily. People with emotional dysregulation might try to avoid difficult emotions and when experiencing them they can easily become impulsive. Another example is that those with emotional dysregulation might be overly negative. As a result, there is a risk for:

  • Anxiety
  • Depression
  • Substance abuse
  • Suicidal thoughts
  • Self-harm

Other symptoms include high-risk sexual behaviors, extreme perfectionism, and eating disorders.

In children emotional dysregulation exhibits itself through temper tantrums, crying, and refusing to talk or to make eye contact.

Over time the condition may interfere with the quality of life leading to interpersonal problems, issues at home and work, or, in the case of children, at school.

Causes of emotional dysregulation

Scientists believe that in the experience of emotional dysregulation there is a problem with the emotional braking mechanism in the brain caused by a reduction in the response of certain neurotransmitters. This leads an individual to experience an ongoing “fight or flight” response whereby the pre-frontal cortex shuts down in times of heightened stress.

There a several possible reasons why a person may develop this condition and it is often co-morbid with another larger mental health problem (see below). Possible causes are:

1. Child neglect

In the case of neglect, there is a failure on the part of the caregiver to cater to the basic needs of the child. Here the caregiver does not provide adequate levels of physical and or emotional care.

2. Early childhood trauma

Whereby traumatic events are experienced early on in life during the critical period of a child’s development.

3. Traumatic brain injury

Brain dysfunction is caused by a dramatic blow to the head, for example.

4. Chronic invalidation

When a person’s thoughts and feelings are repeatedly ignored, rejected, or else judged.

What Is Integrative Medicine for ADHD? A Holistic Health & Wellness Guide

What Is Integrative Medicine for ADHD? A Holistic Health & Wellness Guide

ADHD doesn’t only affect attention. Better considered an executive function and self-regulation deficit, ADHD affects the whole person — the mental, emotional, physical, spiritual, and social self. It increases daily stress and chips away at a positive sense of self. It interferes with self-care and makes it hard to keep healthy habits.

This helps to explain why ADHD is linked to chronic stress, burnout, anxiety , mood disorder , sleep problems , substance use, and other conditions and issues. The reverse is also true: chronic stress and anxiety can worsen ADHD symptoms.

ADHD impacts the whole self, so is treatments must likewise target more than inattention and impulsivity. Integrative medicine is growing in popularity because it’s a treatment approach that addresses symptoms and promotes general health and wellness. Integrative Medicine for People with ADHD: Index of Topics

What Is Integrative Medicine?

Integrative medicine considers the whole person and leverages all options — holistic thinking , complementary therapies , and conventional treatments — in devising a patient’s care plan.

Studies exploring the effectiveness of integrative approaches for ADHD specifically are limited. Moreover, the most common treatments for ADHD are the conventional – medication and psychotherapy. Still, just as ADHD affects many aspects of wellbeing, a variety of treatments and approaches can do the same.

As an integrative practitioner, my approach for treating patients with ADHD is this: If the ADHD symptoms are significantly impairing, I start with medication, and then phase in other strategies, often outside of conventional care. If the ADHD symptoms are mild to moderate, the non-medication and lifestyle approaches can be tried first.

Over time, as the other skills and strategies are employed, the need for medication can be re-evaluated and the dose reduced.

An example of an integrative medicine plan for ADHD may combine psychotherapy (a conventional strategy), stress-management skills (holistic thinking), and omega-3 fatty acids (a complementary supplement).

Conventional Treatments for ADHD

Holistic Wellness and Lifestyle Approaches for ADHD

Complementary and Alternative Medicine (CAM)

  • Brain-gut health
  • Acupuncture

Integrative Medicine for ADHD: Combining Holistic & Conventional Care

Most of the following approaches address ADHD’s secondary symptoms — namely stress, anxiety, mood, low self-esteem, and emotional dysregulation. Treating these factors can help decrease the severity and impairment of ADHD’s core symptoms.

Stress Management and Executive Function

Psychotherapy

Cognitive behavioral therapy (CBT) helps patients develop a greater understanding of their ADHD symptoms and teaches skills that help with executive dysfunction.

CBT aims to improve patients’ problem-solving and stress-management skills by setting realistic goals and teaching organizational and time-management skills to achieve them. This type of psychotherapy can also improve balanced thinking and communication skills by focusing on one’s unique challenges (e.g., history of trauma or other comorbid mental health conditions).

ADHD coaching

Like CBT, coaching helps individuals meet their goals and develop skills to address ADHD-related barriers along the way.

Mindfulness

Mindfulness — a practice that includes meditation as well as awareness shifts in daily activities — has been shown to improve both inattentive and hyperactive/impulsive symptoms, as well as selected measures of attention, emotion regulation, and executive functions1.

By analysis of automatic habits, the practice allows you to change them in the moment. For example, mindful awareness may help you realize that you are procrastinating, and help you tune in to the emotions that are driving the procrastination.

Self-Compassion

A facet of mindfulness, practicing self-compassion is particularly important for mental health. Offering yourself some validation and kindness — “This is hard. I’m stressed. I’m struggling” — will make a difference in how stress is experienced.

How my children's autism diagnoses led to my own

How my children’s autism diagnoses led to my own

Do you see a lot of your child in yourself?

Do you share a lot of the same mannerisms? Have similar temperaments? Think of them as a mini me?

This is how I thought of my daughter (my second child) and myself — people would stop me in the streets when she was a baby to gush over just how much she looked the spitting image of me!

So when she started showing signs of autism from the very young age of one, (although it took until she was six years old to finally have her formal diagnosis), it did lead me to start to wonder if I may be autistic myself.

But I didn’t have time for myself at this stage. I had a three-year-old son — my youngest — who was in desperate need of an autism and ADHD diagnosis and support.

Interestingly, once these two were diagnosed I still had no clue my eldest child, my 13-year-old, who had done so amazingly both socially and academically in primary school, could be on the spectrum. When they started high school, everything fell apart, leading us to find out they are also autistic and ADHD.

After all my children had been diagnosed as autistic, I started reading a book I was recommend about autistic girls to help me to understand and support my daughter better. I decided it would be a good idea to highlight anything which resonated with me. Halfway through the book, I’d highlighted most of it and was hit with the realisation that this wasn’t in reference to my daughter at all. It was explaining so much of what life was like for me from when I was a little girl, right up until now. So many things I had no idea had anything to do with autism, I thought they were just things Anthea did, thought or felt.

Things such as being really sensitive to light and sound, which I knew were related to another diagnosis I have of fibromyalgia; however, I didn’t know they are also signs of sensory and emotional overload. I would get this “funny feeling” in shopping centres a lot, my eyes would go blurry, I’d start shaking, could not concentrate and felt nauseous. My children find it challenging to be in crowded, noisy places too.

I was lucky enough to come across an organisation who were able to fund an autism assessment for me because, as a mum of three children with special needs, I would never have saved the money to pay for an assessment for myself. Their needs would always take precedence.

I am so very grateful that things fell in to place and I was able to get an assessment, as it was totally life-changing for me. The best part of this is that I’m able to learn tools and strategies which help to lessen my autism’s impact.

I am finally learning to feel comfortable in my own skin and understand why I do so many things in the way that I do.

I now understand why I really struggle to socialise in groups, why it takes me so long to get jokes, why I physically hurt when a friend or family member is emotionally upset.

If it wasn’t for having autistic children myself, I would never have known I am autistic. I would never have felt like I fit in somewhere in this world.