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  • Beth Paul

It's all too much. Coping with the inevitable overwhelm of the ADHD brain

I do not have a problem paying attention. In fact, I pay attention extremely well. The problem is I do not have an effective attention filter. I pay attention to everything in my environment which often makes it appear that I am paying attention to nothing.

Imagine you are standing in a noisy, crowded bar. You are trying to have a conversation with a friend who has a voice that is neither loud nor soft. All around you are chattering conversations and the sound of movement and glassware. You strain just a bit - narrowing your gaze and listening ever so intently to your companion. With effort your brain is able to focus on just what she has to say. Now imagine you are working that hard to concentrate EVERY DAY.

At this moment, it is 3:15 in the afternoon. I am sitting in my office and am aware that the ceiling light is overly harsh and making my eyes sore. I have removed my watch as it was bothering my wrist. I am aware of any conversation that occurs in the nearby offices. I am wondering if my child is working on his school work or if I need to go and remind him to get back to work. I am aware that I wish I could remove my shoes but know that I should not take my shoes off at work as it is not professional. And yet, sometimes I take my shoes off anyways because I just cannot stand to keep them on anymore.

A near constant internal dialogue has been present for as long as I can remember. Like any constant companion I often forget that it is in anyway unusual to here a constant commentary in my head. If I am not talking to myself then I am singing, or humming or wondering why Brahms lullaby is stuck in my head again,

The inner dialogue doesn't go away just because I am talking to someone else. If the conversation is particularly interesting it may let up just a little bit. At times, I repeat what the other person is saying to myself to be sure I am paying attention to their words. At times, my inner dialogue is critiquing my communication skills. Am I talking too much? Is the other person bored? Did I just say something awkward?

Intrusive thoughts can be a particularly overwhelming part of my inner dialogue. These thoughts are common among those with ADHD and tend to be upsetting. These thoughts are less troublesome these days, as along the way I learned the importance of not giving these thoughts too much time or attention. They are just thoughts. The less attention you pay them the less often they make an appearance.

To settle my inner dialogue I often listen to podcasts or music. Replacing my inner dialogue with external stimuli. This is effective to a point. I also rely on nature and time spent outside as the natural world can go a long way toward slowing my racing brain. Music can provide tremendous relief allowing my brain to focus on the melody and lyrics of a song rather than on ten other things that may be playing in in.

The problem is, well all of these techniques can help none actually stops that inevitable reality that my brain is constantly in motion. Eventually, the constant motion leads to fatigue, frustration and overwhelm. As overwhelm sets in I become aware of increasing levels of anxiety, my patience decreases, my mood nose dives and my productivity falters.

What is not inevitable is how often this experience occurs and how long it takes to recover. Sadly, for many years I did not understand the circumstances that led to my overwhelm. And, like any enemy it is hard to fight what you do not understand. As a result, what could have been a short episode that could resolve with a bit of extra rest often instead became a drawn out episode of anxiety, depression and exhaustion.

What makes the difference? A plan. As a nursing student, one of the first skills you develop is the ability to create a nursing care plan. These plans teach a fledging nurse the critical thinking process that is needed to prioritize and address the symptoms a patient is experiencing.

A care plan identifies a nursing diagnosis, provides evidence to prove the problem exists or a risk of the problem exists and identifies interventions that a nurse will take to address the need. Methods to assess the effectiveness of the intervention are also addressed.

At some point, after a bit of therapy and increased self awareness, I began to realize what a powerful tool the nursing care plan provides in managing other problems that occur in my life and that of my family. One such area is managing overwhelm.

What does my plan look like? And how can you create one that works for you? Grab a blank journal page or scrap of paper and lets create a plan.

Lets start with the our diagnosis, or problem. I'm going to use "Overwhelm and exhaustion related my ADHD brain, rejection sensitivity dysphoria and sensory sensitivity". This is general, but usually some mix of these is what leads to my overwhelm. Feel free to copy my words or find a phrase that describes your overwhelm. If you can identify specific triggers include them.

Next we need to figure out how to know when my problem exists. What tells you that you are overwhelmed or headed that way?

For me, annoyance and irritability are top symptoms. Feelings of fatigue, anxiety and sadness are also common. In your exercise take time to consider how you feel and how your thinking changes as you become overwhelmed. Be as specific as you can. After your diagnosis add the words "As Evidenced By" and the symptoms you need to watch for.

With the problem identified its time to establish a plan. What self care behaviors have helped you to cope in the past? Do you feel better after a long walk? Time journaling? A night out with friends? When you are overwhelmed do you need time alone or do you recharge with others? Does a cup of tea help? Do you enjoy a glass of wine or does one glass lead to four glasses and a brutal hang over?

This is the guts of your plan. Take your time and make a comprehensive list. Are there things you often turn to when overwhelmed that are not effective? Make some notes on those too. Pay particular attention to tendencies to engage in harmful or self destructive behaviors.

You may find it useful to create an emotional first aid kit. Find a beautiful box and put items in it that may help during periods of overwhelm. Some items to consider include a few special letters or cards from loved ones, your favorite essential oil or two, chocolate, your favorite tea, a stress ball, a book of jokes or a playlist of your go to songs. Include items that will help you unwind.

Include in your journal exercise ways to identify if your plan is successful. How do you know that your stress and overwhelm are improving? Are you happier? Do you crave fewer sweets? Sleep better? Try to identify specific measures that tell you things are going well.

Lastly, include a plan for when things are not getting better. What if you are trying everything and your overwhelm just isn't getting better? Or if your difficulties are unbearable. Have an emergency plan. Who can you call for help? When should you call your doctor, therapist or a crisis line?

Once you have your plan for managing overwhelm keep it handy, perhaps in your emotional first aid kit or on your refrigerator. That way, when things start to become to much you will be armed and ready.

Do you have any other tips for managing overwhelm? Leave them in the comments!

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