ADHD: Perspectives From A Neurodiversity-Affirming SLP - Part 2
Author: Kendra Wormald, Reg. CASLPO Speech Language Pathologist
Date: Wednesday, September 04, 2024
This article will navigate through a possible day experienced by someone with ADHD. Throughout the excerpt you'll learn about the specific personal challenges and barriers to communication as well as evidence based education to provide rationale for why and where ADHD behaviors show up in life.
Disclaimer: ADHD may be experienced differently from person to person. A daily challenge for one person may have never been experienced by someone else with ADHD
Let's take a look at Sally's Monday.
Sally wakes up late. Although it's not the first time she's tried to get up this morning. Her alarm went off 20 minutes ago but she became overwhelmed by the thought of all the tasks she needed to complete that day. Instead of being able to get up and start on this to-do list, she's stuck, frozen. No matter how badly she wants to start, she cannot.
This phenomenon is referred to as ADHD paralysis.
Note the intentional wording of 'not able to' instead of 'didn't want to'. Often with ADHD there is an average, if not increased, desire to do tasks compared to neurotypical brains. It has nothing to do with not 'wanting to' do the task. Often this is perceived as procrastination or laziness - neither of which are factual. Starting tasks may be all the person is able to think about as they sit there staring 'into space', scrolling their phone or avoiding the task and doing something else. ADHD paralysis may show up in your life in different ways:
(PsychCentral, 2024)
ADHD mental paralysis: A state of overwhelm from too many overlapping thoughts and emotions. This can make it challenging to move, speak or express your thoughts and emotions effectively
ADHD task paralysis. A freeze in motivation may result in task avoidance, brought on by a looming to-do list and sense of dread.
ADHD choice paralysis (analysis paralysis): This is a sense of overwhelm related to too many choices or feeling an unbearable weight of making a necessary decision
Sally is now forced to get up because the dread and consequence of being late for her morning meeting with her boss weighs heavier than the thoughts and emotions around the paralysis. So Sally gets up, quickly. Rushing through her morning routine, Sally left her house with enough time to get to work. However, she forgot she had to get gas and didn't put her keys where they belong - two tasks she had put off the previous night, which have now made her very late.
Working Memory is a form of memory that allows you to hold a limited amount of information to use in the moment. This memory ability for example, helps you recall what was said previously in a conversation. ADHD challenges with working memory may impact reasoning, decision-making, behaviour and, perception of time and problem solving.
Forgetting things like needing to get gas, or where you put your keys or phone down may be directly related to challenges with encoding information, not necessarily an issue with long-term memory. Encoding information pertains to moving the information from the short-term or working memory to your long-term memory. The ADHD brain is often moving too fast to effectively encode (capture, organize, imprint) necessary information to support later recall.
“ADHD is like having a Ferrari engine for a brain with bicycle brakes. Strengthen the brakes, and you have a champion.” – Edward Hallowell
Sally gets to work late, and starts to rehearse her explanation for her boss, but she doesn't really know how to explain what happened that morning as she doesn't want to be perceived as lazy. Sally goes into the meeting already flustered, tired and anxious. She starts the meeting by giving three different reasons why she's late. She speaks very quickly, blends her words together, repeats herself with different words and goes on two side-stories, giving much more detail than necessary.
Sound familiar? Your thoughts and emotions around communication events and perceptions of yourself as a communicator WILL impact how you communicate. See our article on how to address your communication thoughts and emotions directly.
The meeting finishes and Sally walks to her desk feeling even worse. She attempts to start on her presentation that is due at the end of the workday however, she can't stop thinking about the meeting she just had and how poorly she communicated. When she gets to her desk, she can't recall what the two new tasks her boss had asked her to do, just seconds prior. Sally thinks about the opportunity for a promotion and watches it slip away from her as she continues to feel disappointed and frustrated with herself.
Although mind wandering, also referred to as " off-task thought", impacts about 50% of daily thinking time for the 'average' brain, it is often deliberate such as when brainstorming ideas for a proposal while listening to a podcast on a similar topic. Contrary to this, mind wandering in the ADHD brain is often spontaneous and thoughts may not be related to the other.
When Sally is finally able to start her presentation preparation, within 10 minutes she gets distracted by a side-task. This task isn't any more important, but appears easier, less effortful and more enjoyable, so she puts off the presentation. During this side quest, an email notification comes in. She feels the need to open it right away. The email requests for performance numbers from the previous month. So Sally walks to the records room to get this information. On the way she stops to say hello to a coworker and asks her about her weekend. The coworker speaks slowly and gives a lot of information. Sally has a hard time following along, starts to think about her lunch that she forgot at home, and by the time it's her turn to respond, she's forgotten what she wanted to share and her mind goes blank. When she does remember her thought, she says it right away - cutting off her coworker. The coworker now appears to be frustrated and Sally feels anxious and guilty because this has happened nearly every time she speaks to her coworkers. Sally has noticed people don't often start conversations with her anymore, and she struggles to do this herself so the team morale feels disconnected. Following this communication breakdown, she returns to her desk to work on the presentation. Within 30 minutes she gets a follow-up email asking for those performance numbers - the task she completely forgot about.
ADHD significantly impacts the ability to effectively use executive function skills. Without these skills, communication may look like:
(ABI Network, 2024)
Impaired ability to make judgements about topics and tone that are appropriate for the context
Blunt and insensitive speech content
Reduced ability to change and adapt communication style
Significant challenges generating a topic
Difficulties demonstrating empathy reduced perspective taking ability which may impact what and how they say things.
Talking too much and saying things that are ‘over personal’
Significant difficulties thinking of conversation topics.
Misinterpretation of social situations,
on-verbal communication may be inappropriate to the situation and relationship.
Reduced ability to judge and understand other people’s communicative intent and motivation.
Reduced motivation to engage in interaction. Lacking excitement and interest in voice, reduced questions, reduced amount of information shared, withdrawal from conversations
Sally tries to get rid of all distractions and really get down to work. As she continues to work on the presentation, Sally finds it helpful to walk around and fidget with her hair tie to help her focus. After feeling productive, she looks at the time and panics. She thought she was ahead of the game but misjudged how much time each subtask of the presentation would take her. The presentation is now due and she still has some slides to complete and needs to practice.
Time Blindness is the inability to accurately decide how much time it takes to get something done or sense how much time has passed. For example, an ADHD brain considering how long it will take to get ready and drive to an appointment can be challenging and often leads to being frequently late. To some this may come across as you being inconsiderate of their time which leads to relational breakdowns, less social invitations and less trust - even if being inconsiderate is not the intention. Time blindness may put you in 'waiting mode', in which you are unable to be productive for a long time leading up to the appointment you're waiting for, no matter how far away it is. Often this is why it's so challenging for people with ADHD to have appointments in the middle of the day.
Sally grabs a coffee after work hoping it will help her energy and focus - when actually it seems to make her even more tired and uninterested. With these emotions and reflection of the day, she decides to scroll on her phone to 'escape' the overwhelm for a moment. Sally's partner Sam reminds her that she needs to practice her presentation or it won't go well. Sally was about to start but being told to do something often sets her back into 'freeze' mode. She knows her partner is trying to be supportive but she's not able to communicate these thoughts and emotions effectively, which led to yelling, speaking quickly, accusatory and aggressive language, and speaking in a way that was confusing to understand.
Emotional dysregulation (ED) inhibits our ability to, "differentiate between being rejected vs critiqued. So...If we feel someone rejects and disregards our sense of self and way of thinking, why WOULD we want to listen to them?" (Coaching with Brooke, 2024). Imagine wanting to start a task and thinking about it all day but you're stuck in 'freeze' and overwhelmed, then someone tells you that you need to do that task - but you're still 'frozen'. Imagine how frustrating that would be. ED can lead to reactions that are disproportionate to the situation which in this example, may come out as anger and yelling. As you can see with both Sally's coworker and partner Sam, her challenges lead to social communication breakdowns and subsequent reduced desire from others to communicate with her.
Sally feels she continues to fail at her job which makes it hard for her to start her other responsibilities as she fears she'll disappoint someone, including herself. So, she leaves her responsibilities such as laundry, budgeting and cooking for 'tomorrow', where the cycle begins again.
Some or even most of this excerpt of Sally's day may be your reality. As you learned, ADHD can be limiting and debilitating at times, across different areas of your life. A Speech-Language Pathologist can help you navigate your unique challenges and limitations resulting from ADHD.
To speak with a psychotherapist or one of the speech-language pathologists at Well Said: Toronto Speech Therapy, schedule an initial consultation by clicking the link below or calling (647) 795-5277.