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Reducing Uncertainty with ADHD through Occupational Therapy

I’ve recently been learning more about how emotions are experienced and their energy use. One piece of information that really resonated with me was that experiencing uncertainty tends to be very ‘expensive’ in terms of emotional and cognitive energy. Think of all those times you didn’t know what to expect. For myself, I can viscerally feel the increase in heart rate, shortness of breath, muscle tension and feeling of anxiety just thinking about the word ‘uncertainty’. This new learning helped me to reflect on the experience of uncertainty and ADHD, and some of the trademark features such as time blindness, decision paralysis and decreased working memory (i.e. “Where did I put my phone? I just had it!”) that could all contribute to the experience of uncertainty. I also know that fatigue often accompanies ADHD for myriad reasons (e.g. masking, feeling anxious when running late for a meeting, procrastination, trying to fit into a neurotypical world, etc.). It’s made me double down on the belief that adding structure to the day and building consistency with routine is integral to reclaiming energy and reducing the experience of uncertainty.

Although I’ve already written about routine and organization in previous posts, I wanted to revisit some of the important strategies in this blog, as well as add in a few new strategies to try.

· Time Management and Planning: I recognize that this one is hard. Even when you overestimate how long something will take, it still ends up taking longer than expected. And sometimes what feels like five minutes was actually 45 minutes. So how can time management skills be reasonably attained. This one often takes a lot of trial and error, especially because adult ADHD can show up in so many different ways. But here are some tried and true methods:

a. Set timers: Maybe you read this more like “sEt TiMerS”. Annoying, yet when used consistently this can be really helpful when we get stuck on a task or have difficulty understanding how long a task might take. One strategy in particular that been repeated throughout ADHD trainings I’ve taken is to use a visual timer. This can be in the form of an app (e.g. ‘Time Timer’) or a physical timer (just Google ‘visual timer’ and you’ll see what I mean). This is particularly helpful when tracking the passage of time is difficult and to more accurately allocate time for tasks in the future.

b. Build consistency into weekly activities: This is often helpful for things like laundry, grocery shopping and cleaning. It might not be feasible to do all of these things in one day. Plus that sounds exhausting. However, picking one task per day might be a way to follow through more consistently on these typically less desirable activities. However, once you decide that Mondays are laundry day, you must stick to it and push against that “I don’t feel like it” voice. Focus on how much better you’ll feel when you have clean clothes for the week. Also think of something like laundry as having multiple steps, where you can check off your progress with each step and do a little happy dance or give yourself a pat on the back. Listening to a podcast or music while folding laundry or putting it away might also make these tasks a bit easier to get done.

· Routines: This is something that I work on with anyone willing to hear me out on how important routines are. Usually I focus on setting up a morning routine and evening or bed time routine at the beginning of sessions. I’m a fan of having routines to bookend the day, while also ensuring that someone isn’t scheduled for every minute of the day. I think having these two routines strikes that balance. It often takes time to implement a routine consistently, which is why it’s important for you to identify what you think will be most helpful at these times (although I’m always happy to make suggestions). I usually recommend that routines are no more than 2-3 steps to ensure simplicity. Again, implementing regular routines may take a few weeks, and it’s normal to stick with it for a few days and then miss a day or two. Don’t let that derail you! You can restart a routine as many times as you need to, and that creating a habit takes time. That’s also why I think it’s important to have someone who can help keep you accountable (such as an Occupational Therapist, friend or partner).

· Organization: This can be a toughy, as the thought of tackling all the piles, papers and daily items can feel really overwhelming and lead to procrastination and paralysis. One place that you can start is ensuring that you have a regular spot to put important items like your keys, wallet and phone. Usually a dish or bowl by the front door can be helpful. Using clear storage can also be really helpful so that it’s easy to see where stored items are being kept. The idea of a ‘launch pad’ was also recently introduced to me. This is where you have an area near the front door for every individual of the home where the items to leave the house and start the day are kept. This might include a school or work bag, shoes and jacket. This makes it easier to get out the door in the morning, and saves you those few precious minutes that might mean making it to work on time.

Although these tips are somewhat general, I hope there’s something in here that you find useful. As always, feel free to reach out with any questions at Know that you’re not alone in your experiences and the daily frustrations you might be encountering, and I’m always happy to provide support and lend a listening ear.

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