Every January, you promise yourself this will be the year. You may think: This time, I’ll finally lose the weight, cut back on drinking, stop feeling so anxious, or fix that relationship I’ve been neglecting.

You may make it through January, but the failure rate for many New Year’s resolutions hovers around 80%. After a month or two into the new year, you might have given up on your goal and may be carrying the additional weight of disappointment and self-blame.

If this sounds familiar, you’re not alone. More importantly, you may not be failing because you lack willpower or discipline. When you find yourself making the same resolutions year after year without lasting change, it may be time to consider a different possibility: how mental health is involved.

Why Do I Keep Failing at My New Year’s Resolutions?

If only 9% of Americans ultimately keep their resolutions, this means the vast majority of people struggle just like you do. But while fitness gurus and self-help books will tell you to set smarter goals, track your habits, or find an accountability partner, these strategies often miss a crucial truth: behavioral change is nearly impossible when underlying mental health conditions are working against you.

The Willpower Myth: Why “Just Try Harder” Doesn’t Work

For decades, we’ve been told that willpower is the ability to resist short-term temptations in order to meet long-term goals. But actually, the very belief that you just need more self-control may be setting you up for failure.

Success is often influenced by a combination of personality traits, environmental factors, and social contexts rather than willpower alone. In reality, when you’re battling anxiety, depression, undiagnosed ADHD, or trauma, your brain is working with fundamentally different resources.

How Mental Health Conditions Sabotage Your Goals

The resolutions you make year after year to lose weight, drink less, manage anxiety, and improve relationships aren’t random. They’re often symptoms of deeper struggles that haven’t been identified or addressed. Consider what other factors might be at play, and give yourself some newfound grace.

When Depression Derails Your Best Intentions

This year, you may plan to exercise more, eat better, or reconnect with friends. But anxiety, depression, and self-esteem issues are common conditions that nearly 21 million adults in the U.S. deal with each year (as of 2021 data).

While it manifests differently from person to person, depression doesn’t just make you feel sad: it fundamentally alters your motivation, energy levels, and ability to experience pleasure. When you’re depressed, the activities that would help you feel better feel impossibly difficult.

ADHD: The Hidden Hurdle

Many adults struggle for years without realizing they have Attention Deficit/ Hyperactivity (ADHD). They may just think they’re lazy, undisciplined, or fundamentally flawed. Individuals with ADHD may struggle with impulsivity, emotional regulation, and consistency, leading to self-sabotaging behavior like missed deadlines, emotional outbursts, or difficulty following routines.

Living with ADHD can make it difficult to reach your goals and find a routine that works. Your resolution to wake up earlier, stick to a budget, or stop procrastinating faces up against mental health factors that no amount of determination or “willpower” can overcome.

Anxiety and the Self-Sabotage Cycle

If you want to be less anxious this year, you might make resolutions to meditate, practice self-care, or “worry less.” But anxiety has a way of hijacking your best efforts, whether it’s related to politics, finances, relationships, the holidays, or more. These deep-rooted beliefs and thinking patterns can fuel all kinds of fears that can result in procrastination or avoidance. If left unchecked, this can lead to general anxiety, social anxiety, and depression.

Ironically, the very act of setting ambitious goals can trigger anxiety about failure, which confirms your worst fears about yourself. It’s a cycle that feels impossible to break on your own. Luckily, anxiety (and depression and ADHD) is a very treatable and common condition that doesn’t have to get in your way.

Depression, ADHD, and anxiety are not the only mental health issues that can make reaching your annual goals a challenge. Substance abuse challenges, trauma, obsessive compulsive disorder (OCD), and others might be at play. The first step, though, is doing some self-evaluation and talking to a licensed mental health professional.

What Does Self-Sabotage Really Look Like?

Getting in your own way isn’t always obvious, and it doesn’t always look like giving up. Knowing the below signs of self-sabotage can equip you with the tools to interrupt your harmful patterns and start reaching your goals:

Low self-esteem and unfounded beliefs about being deficient, not good enough, incapable, or unintelligent contribute to self-defeating behavior. These core beliefs fuel fears about performance and can cause procrastination or avoidance.

If you find yourself getting in your own way, remember: These patterns aren’t character flaws. They’re often learned responses to unmet emotional needs. Plus, they’re incredibly common among people with undiagnosed mental health conditions.

How Do I Know If I Need Professional Help?

If you’re reading this and wondering whether your resolution struggles signal something deeper, try asking yourself these questions:

Prioritizing your mental health needs doesn’t have to follow a significant or traumatic event in your life. It can be the natural next step if you notice the little things adding up and your resolutions getting harder and harder to achieve.

What Can Therapy Actually Do for My Resolutions?

Despite what some may think, therapy isn’t about having someone tell you to try harder or hold you accountable. It’s about uncovering and addressing the root causes that have been affecting your efforts all along. Finding emotional healing starts with a diagnosis, if applicable, exploring root causes, and building the skills to manage your needs.

Accurate Diagnosis Changes Everything

A thorough evaluation for a specific condition, or a few, might seem scary and overwhelming. But getting an accurate diagnosis gives you clarity. Suddenly, your struggles have a name and a framework. Whether you have ADHD, anxiety, PTSD, depression, or another condition, early identification improves the effectiveness of treatment and improves your overall quality of life. You’re not broken or lazy: you’re dealing with a legitimate challenge that has real solutions.

Therapy Addresses the “Why,” Not Just the “What”

Resolutions and therapy may share the same end goal of bettering yourself, but they approach it in very different ways. Resolution-setting focuses on behavior: eat less, exercise more, save money. Therapy digs into why those behaviors have been so difficult to sustain.

A skilled therapist can help you:

You Learn Skills That Last Beyond January

Therapy is not meant to give you a one-time fix for a sticky situation or a script for handling one tough conversation. Therapy approaches are long-term treatments that can be very helpful in creating lasting change. Some common frameworks include Cognitive Behavioral Therapy (CBT), Internal Family Systems (IFS), or Acceptance and Commitment Therapy (ACT), to name a few.

Making Therapy Your Resolution This Year

This year, instead of resolving to change your behavior through just more willpower and determination, consider making a different commitment: to understand yourself better and get the support you deserve.

When finding a therapist, look for someone who:

Seeking therapy is about acknowledging that you’ve been fighting an uphill battle with limited tools and wanting to make a change, not admitting defeat. With proper treatment, you can work towards genuine self-motivation.

Take the First Step Towards a Healthier You

Change takes time, and it doesn’t have to start with a sweeping life overhaul. It can start with one phone call, one appointment, one honest conversation about what you’ve been struggling with. Setting New Year’s resolutions already proves you have the desire to change, so now it’s time to get the support that makes change possible.

Find a therapist near you who can help you understand what’s been holding you back and build a path forward that actually works for your life and your unique circumstances.

ADHD burnout is a term increasingly used to describe the feeling of overwhelm, exhaustion, and stress that people with ADHD may experience due to their condition. According to research, up to 93% of adults with ADHD experience burnout symptoms (ADDA, 2021) compared to only 30% of the general population (AID, 2019). This article will explore the link between ADHD and burnout, the early warning signs of burnout, and what ADHD burnout feels like.

ADHD vs. Burnout

Before we dive into ADHD burnout, it is essential to clarify what ADHD is and how it relates to burnout. ADHD, Attention-Deficit/Hyperactivity Disorder, is a common condition that makes it difficult for people to regulate their attention, energy, emotions, and behavior. Adult ADD is a neurological disorder involving differences in brain structure and function, particularly in focus, impulse control, and executive functioning. On the other hand, burnout is a state of physical, emotional, and mental exhaustion caused by prolonged stress (WHO, 2021). Burnout looks like feelings of energy depletion or exhaustion, increased mental distance from or feelings of negativism or cynicism, and reduced personal and professional efficacy.

So, What is ADHD Burnout?

ADHD burnout results from unmanaged stress and frustration from a lack of control and progress that individuals with ADHD may experience. It is the feeling of being stuck in a rut and unable to move forward, no matter how hard you try. The most significant misunderstanding of burnout is the belief that it’s caused by stress.

The goal for burnout recovery isn’t to remove stress by taking a vacation or being less passionate. The goal is to increase our agency and efficacy in our personal and professional life. If our wheels are spinning, and our car is moving, we’re not in burnout but in flow.

How Common is ADHD Burnout?

The risk of burnout is over 50% higher for people with ADHD (Kawa, Pisula & Merta, 2021). Burnout can significantly affect employers, including up to $300 billion annually in lost productivity and healthcare costs (Harvard Business Review, nd). Burnout can make people 200% more likely to become depressed, with the risk of suicide quadrupling by 400% (World Health Organization, 2019).

Signs of ADHD Burnout

Identifying the early warning signs of burnout is essential to prevent it from becoming chronic. Here are some of the most common early warning signs of ADHD burnout:
1. Unproductive: When you find yourself unable to accomplish anything on your to-do list, even the simplest of tasks, it could be a sign of ADHD burnout.
2. Unmotivated: You might need help feeling motivated to do anything, even things you usually enjoy.
3. Difficulty getting started: Starting a task can feel like an insurmountable obstacle, even if it’s something you know you need to do.
4. Poor time management: You might struggle to manage your time effectively, feeling like there need to be more hours in the day to accomplish everything you need.
5. Lack of follow-through: Starting something but needing help to finish it can be a sign of burnout.
6. Chronic procrastination: Putting things off until the last minute and then feeling overwhelmed by the amount of work to do can be a sign of burnout.

What Does ADHD Burnout Feel Like?

ADHD burnout symptoms result from prolonged burnout and can be emotional and physical symptoms of ADHD burnout. Here are some of the most common symptoms:

• Overwhelmed: Feeling like you have too much on your plate
• Exhaustion: Feeling tired even after getting enough rest and experiencing physical fatigue.
• Lack of Motivation: Difficulty starting or completing tasks, feeling a sense of apathy or disinterest in once enjoyable things.
• Brain Fog: Difficulty concentrating, forgetfulness, and trouble with memory recall.
• Emotional Dysregulation: Mood swings, heightened irritability, and increased emotional sensitivity.
• Physical Symptoms: Headaches, digestive issues, and muscle tension.

The ADHD Burnout Cycle

Understanding the cycle of ADHD burnout is crucial as it can provide insight into the causes and manifestations of burnout in individuals with ADHD. The cycle has five phases:

1. The Honeymoon Phase
2. The Stress Phase
3. The Grind Phase
4. The Strain Phase
5.  The Burnout Phase

The first phase is characterized by hyper-focus and high productivity, while the second phase begins when individuals with ADHD encounter job/work stressors. As demands continue to mount, individuals with ADHD may push themselves too hard, neglecting self-care and rest, leading to the third and fourth phases. The final phase of the cycle consists of a total breakdown in an individual’s ability to function and cope with daily life.

Burnout Recovery

If you’re experiencing ADHD burnout, there are three decisions you can make to begin the recovery process and regain a balanced and fulfilling life.

Change Yourself

The first decision involves changing yourself and addressing the internal factors contributing to your burnout. This includes understanding the symptoms and signs of burnout, creating a self-care routine, practicing mindfulness and relaxation techniques, and getting professional help. By focusing on these aspects of your life, you can begin to heal and recover from burnout.

Change Your Situation

The second decision involves changing your environment/situation, which consists in setting boundaries and advocating for yourself in your personal and professional relationships. You can do this by communicating your needs and limitations with friends, family, and colleagues, setting healthy boundaries and learning to say no, advocating for adjustments or accommodations in your workplace or school, and taking a break or sabbatical to recharge and recover. By addressing the external factors contributing to your burnout, you can create a more supportive and sustainable environment for yourself.

Change Your Career

The third and final decision involves changing your career, which is the most drastic but sometimes necessary step to fully recover from burnout. You can assess your current job and situation, identify stressors, triggers, and frustrations, examine what work means to you, and explore future possibilities.

Additionally, you can create a life and career plan, build new skills that can be beneficial in transitioning to a new career, network and seek out mentors in a new field to gain insight and perspective and pursue a career that aligns with your values, purpose, and aspirations.

In conclusion, understanding the cycle of ADHD burnout and taking steps to manage its symptoms and effects is critical for individuals with ADHD. Making decisions to change oneself, environment, or career can help individuals recover from burnout and lead a balanced and fulfilling life.

The GoodTherapy registry might be helpful to you to find a therapist if you have experienced ADHD burnout. There are thousands of therapists listed who would love to walk with you on your journey. Find the support you need today.

by Dr. Steven D. Graham, Licensed Psychologist, in Tampa, FL

A Look Inside the ADHD Brain

If you could look inside the brain of someone diagnosed with untreated ADHD, what would you see? Would the brain look and function differently from a non-ADHD brain? If so, how? In this article, we will look at the neurocognitive functioning of the ADHD brain.

First, however, it might be important to ask what, exactly, is ADHD? Some mental health professionals still utilize the term “ADD.” What we used to believe was that someone had either an attention disorder or a hyperactivity/impulsivity disorder, or sometimes both; “ADD” was shorthand for ADHD without the hyperactivity. What we now realize is that ADHD is one disorder: sometimes the inattention is prominent; other times the hyperactivity or impulsivity seems to be. Often both sets of symptoms occur together.

Our Brains Can Heal!

Neurocognition refers to what happens in our brains and nervous systems that affects the way we think. You may imagine that if something is different or “wrong” in the brain, then the situation is hopeless. Indeed, in years past, neurologists would often shrug and say they could not do much if something were awry in our brains. But what we have discovered over the past 30 years, however, is the phenomenon of neuroplasticity, our brain’s amazing ability to repair, re-route, and restore functioning. Our brains find a way to heal! Often this takes time, but sometimes we begin to see glimpses of improved brain functioning within just a few weeks of beginning treatment. We have also learned ways of assisting that process, which we will explore in later issues.

This is good news for all of us, since many of us sustain some type of brain injury, including life’s traumas that come our way. And, once our brains begin to heal, the way we think and process information will improve. As a result, we can work to enhance how we take in information, how we encode and decode information, and how we store and retrieve data when we need it. We can also then enrich how we make decisions and exercise sound judgment. It is also amazing to see how individuals with ADHD often discover, on their own, workarounds and tools to help them achieve and succeed in life.

People with ADHD may be labeled as narcissistic, bipolar, histrionic, or some other disorder both by those frustrated with these behaviors and by professionals who are ill-informed. In either case, the person struggling with ADHD continues to feel unseen and misunderstood, which only deepens the sense of being an outcast.

What Causes These Particular Symptoms?

It is one thing to describe the symptoms of ADHD, but I think it is also helpful to understand what is taking place in the brain to produce those symptoms. It goes without saying that in this article I will not be able to explore everything in the ADHD brain, so I will focus on some of the most important highlights. According to the latest research,* the prefrontal cortex (PFC) in an ADHD brain is underactive. The PFC is the executive center of the brain, where we plan, organize, strategize, prioritize, exercise restraint, and make good decisions. What I want to do now is to look at three further differences in the ADHD brain.

Brain and Brain-Part Size

Functional imaging shows that the untreated ADHD brain is smaller than the non-ADHD brain. This difference is greater in children than in adults, revealing that the ADHD brain matures at a slower pace than non-ADHD brains. Further, the amygdala (which processes fear and threats) and the hippocampus (responsible for a great deal of learning and memory), both parts of the limbic system, the emotional center of the brain, also tend to be smaller, suggesting that regulation of oneself may be difficult without some additional help. (This information comes from the largest worldwide review of ADHD patient brain scans, conducted by Radboud University Nijmegen Medical Centre, Netherlands, in 2018.) For example, many with ADHD seem to have no fear. They sometimes take unnecessary risks or engage in hazardous sports or activities, while others can be particularly fearful and may wrestle with one or more of the anxiety disorders.

Neurotransmitters: The Communication System of the Brain

Arguably the most important finding regarding ADHD is the abnormally low levels of neurotransmitters in the PFC. This impacts a person’s ability to bypass urges or exercise discipline or make difficult choices. As previously noted, the PFC as the executive center of the brain (which we will discuss further in the next article) is responsible for planning, deciding, prioritizing, organizing, and everything necessary to resist impulses. It enables us to escape the cycle of stimulus-response by adding the important intermediate step of thinking.

Neurotransmitters are what our nervous system uses to communicate between nerve cells. The two most important neurotransmitters of the PFC are dopamine and norepinephrine. Without adequate levels of dopamine, we feel bored and unmotivated. Life can seem dull. Dopamine is largely associated with a sense of feeling rewarded. If I am not getting enough dopamine naturally, I will go after it in other ways, hence the attraction toward that which is fun, novel, or stimulating.

Norepinephrine, on the other hand, is associated with alertness and arousal and can speed up my reaction time. Without adequate norepinephrine, attention and focus can be blunted. Taken together, these low levels of dopamine and norepinephrine (along with the other developmental challenges of the brain noted above) impair one’s ability to be still, to self-regulate, to concentrate, and to make sensible choices.

Two Ways Dopamine Gets Released

Let’s dive just a little deeper into dopamine. We have found that dopamine is released in two fashions, essentially: by tonic release and by phasic release. Tonic release refers to the normal supply which is steadily released for us in the brain, while phasic release describes the process of getting dopamine from the environment. In the ADHD brain, tonic release basically underperforms while phasic release overperforms. In other words, in the non-ADHD brain, where dopamine is released normally, there is a steady, ongoing source of dopamine available, especially to the PFC. The opposite is true for the ADHD-brain: the tonic or steady release of dopamine does not occur efficiently at all.

Phasic release, on the other hand, which occurs when some stimulus from the environment enters the situation, boosts the dopamine in the PFC. In other words, if I am not getting enough tonic release of dopamine on a regular basis, then I am especially sensitive to anything environmental — phasic — which will produce dopamine. This means that when the brain is dopamine-hungry, it will get dopamine anywhere it can. If that happens naturally (as in the non-ADHD brain), we find ourselves easily rewarded and content. If it happens by outside stimuli (as in the ADHD brain), we will seek arousal and reward anywhere we can.

How It All Works Together

In summary, if we look at these three aspects of the brain and brain functioning — 1) brain and brain-part size, 2) neurotransmitter activity, and 3) less-than-adequate tonic release of dopamine — we begin to understand why someone might be hyperactive/impulsive along with inattentive. With the relative sizes of the amygdala and hippocampus, first, we see how someone with ADHD may have an impaired fear-response. We can also understand that if the hippocampus is affected, then my ability to put information into memory and be able to retrieve it might be compromised.

Second, if my PFC is not receiving adequate amounts of dopamine and epinephrine, then I will feel unmotivated to persevere, and my ability to delay gratification will be compromised. My life will feel drab unless I spice it up a lot, which can get me into trouble of all kinds. Third, if the tonic release system of adrenaline is underfunctioning, then I will rely on my ability to use the environment to enhance the phasic release of adrenaline, which will leave me distracted and searching for dopamine-producing stimuli.

I hope this brief overview helps to explain why ADHD symptoms exist just from a look inside the brain alone. When we focus on enhancing a healthy release of dopamine and norepinephrine in the PFC, function is dramatically improved. What is more, we are discovering ways of improving the size and action of the amygdala and hippocampus using both pharmaceutical and non-pharmaceutic means.

________________
*See CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder), founded in 1987, http://chadd.org. See also the research of Dr. Daniel Amen at www.amenclinics.com. In his Healing ADD: The Breakthrough Program That Allows You to See and Heal the 7 Types of ADD, Dr. Amen provides actual SPECT (Single Proton Emission Computed Tomography) images of the various types of ADHD from actual patients his clinic has treated.

by Mary Romm, Licensed Professional Counselor in Gloucester, VA

The Scoop on Parent-Child Interaction Therapy

Are these some of the thoughts inside your head?

“My child is out of control.”

“I don’t enjoy spending time with my kid anymore.”

“My kid hits/bites/kicks me.” 

“Another daycare kicked my child out today.”

Are you ready for help? 

Who PCIT Can Help

As a therapist, I’ve utilized Parent-Child Interaction Therapy (PCIT) to help children ages 2-7 who have extreme behavioral challenges and seen them learn to listen and behave. I’ve used PCIT in my work with kids who had to wear a monitoring bracelet because they ran away so much, broke mirrors in a rage, and used the shards to carve up furniture, or parents were ready to commit them. Those same kids then listened to their parents, no longer engaged in extreme attention-seeking behaviors, and were able to calm down when they were upset and even talk about their feelings. I’ve seen it work with less intense cases, too, but those aren’t as fun to write about. PCIT works. 

PCIT can treat most concerns related to children’s behavior. This includes ADHD, anxiety disorder, autism spectrum disorder, oppositional defiant disorder (ODD), selective mutism, trauma-exposed children, and more.

So What Is PCIT?

Parent-Child Interaction Therapy is an evidence-based approach that has 50 years of research behind it. Research shows it keeps children out of therapy for up to seven years, when they hit adolescence and their brain begins to rewire. Lots of the skills you will learn in PCIT will always be relevant — many of them are as good with 6-year-old kids as they are with teens or even adults. PCIT is not a therapy where another adult takes your child and works with them for an hour before bringing them back to you, and you don’t know what they did in that hour. As a therapist, I love working with this age range because I know early intervention is key. (Also, angry 5-year-olds throwing chairs aren’t nearly as scary as angry 14- or 15-year-olds.)

How Does PCIT Work?

There are two phases to PCIT. The first phase is called Child-Directed Interaction, or CDI. I like to picture CDI as laying the stable foundation of a house. CDI teaches you the skills that play therapists use. It helps you begin to enjoy playing with your child again and learn how to manage their behavior with positive attention alone. In this first phase, you’ll already see a huge reduction in behavior issues due to the child receiving quality, purposeful time with the adult and the adult learning many new tactics to manage that child’s behavior without yelling or accidentally reinforcing the behavior. This is foundational work.

The second phase is called Parent-Directed Interaction, or PDI. PDI is where you get specific discipline skills to help you control your child’s behavior. Now that the relationship foundation is completely stable and your skills are memorized, we can move into learning how to consistently and effectively discipline your child.

Throughout PCIT, you’ll track the reduction in your child’s problematic behavior on a form called an Eyberg Child Behavior Inventory, or ECBI. As a parent, you get to rate your child’s behaviors and see how those behaviors change as treatment goes on.

Is PCIT Forever?

Great news! You will graduate from PCIT in as little as 3-6 months if you do the homework and work hard in sessions. PCIT is not a vague therapy where things end when it feels right; there are specific guidelines and instructions on how to graduate from therapy, all of which are parent-driven. 

How Does PCIT Compare to Other Therapies?

Ideally, because PCIT builds that strong foundation in the Child-Directed Interaction phase, it should be done before any other therapy, even before trauma therapy. Trauma therapy does include several PCIT elements; thus, it is done after PCIT. PCIT should especially be done before talk therapy, as PCIT has the research base behind it. Once kids feel safe and secure in their relationship with their parents, and once parents know how to consistently handle their child’s behaviors, then other therapies can be attempted. However, they usually are not needed at that point. 

Is PCIT Covered by Insurance?

Yes, as long as your insurance has mental health care coverage and your therapist accepts insurance or is able to be an out-of-network provider, PCIT should be covered.

 To learn more about PCIT, please visit this PCIT info page and PCIT International’s page for parents.

 If you live in Virginia and want to start online PCIT for your child, please visit check out Mary’s practice, Willow Tree Healing Center.  You can find more therapists who use PCIT by searching for therapists in your area and filtering your results by Type of Therapy > Parent-Child Interaction Therapy. 

No one looks forward to rejection, but many people can weather the emotional blow and recover from it without too much difficulty. Individual factors such as resilience, social support, and self-esteem can play an important part in the ability to cope with rejection.

Rejection affects people in different ways though. Not everyone gets over it quickly or easily. In fact, some people experience what’s known as rejection sensitive dysphoria (RSD): a severe emotional reaction that makes it particularly challenging to deal with rejection.

Rejection sensitive dysphoria, also referred to as rejection sensitivity, isn’t considered an official diagnosis, but research increasingly suggests it involves much more than “being sensitive”.

Signs of Rejection Sensitive Dysphoria

The most telling marker of rejection sensitive dysphoria is an extreme response to real or perceived rejection. Most people may experience sadness, disappointment, or frustration after experiencing rejection. But with RSD, rejection or critique can be overwhelming enough to lead to:

• Outbursts of rage or panic
• Feelings of despair and hopelessness
• Beliefs that one has failed or disappointed their loved ones
• Feelings of shame and humiliation

Extreme rejection sensitivity can make it tough to move forward after an experience of rejection. Some people might continue thinking about the rejection throughout the day or into the next, experiencing circling thoughts or even feelings of physical discomfort. Some may also experience low self-esteem or feel frustrated with their inability to prevent the intense emotional response.

RSD doesn’t only happen in response to an actual incident of rejection. These feelings can also develop in response to behaviors they perceive to be rejection. For example, an individual may interpret an instance of friendly teasing as evidence that their friends hate them.

RSD is often mistaken for social anxiety, since both involve a fear of rejection. However, social anxiety generally happens before the experience, not after. People with RSD don’t necessarily feel distressed or uncomfortable when they interact with others, unless that interaction involves something they see as criticism or rejection.

Angry vs. Anxious Rejection Sensitivity

Rejection sensitivity can manifest in many ways. That said, it is common for symptoms to follow one of two clear patterns: high-anger RSD and high-anxiety RSD.

High-anger RSD typically involves symptoms and behaviors such as:

• Outbursts of anger or hostility
• An urge to lash out or get revenge on the person rejecting or criticizing
• Aggressive behavior, either directed at the self or others

With high-anxiety RSD, symptoms may include:

• Avoidance of situations with a possibility of rejection
• Withdrawal from others in order to avoid rejection
• Rumination, or thinking about the experience of rejection again and again

Research also suggests feelings of depression are more likely to develop in people who experience anxious rejection sensitivity. Instead of expressing distress through anger, they can direct their pain inward. These sudden drops in mood may be misdiagnosed as rapid-cycling bipolar.

Rejection Sensitivity and ADHD

Emerging research on rejection sensitivity suggests it is strongly associated with attention-deficit hyperactivity (ADHD). RSD has also been linked to autism. Not everyone who has either condition will also experience RSD, but both conditions seem to increase the risk of RSD.

Carey Heller, PsyD, shares his thoughts: “Rejection sensitivity is often a common issue with ADHD. This is partly due to the fact that many people with ADHD struggle with emotion regulation and may feel emotions more intensely.” Emotional instability, or trouble regulating mood and emotions, affects many people living with ADHD.

In addition, people with ADHD often have trouble with behaviors that come normally to others, such as sitting still or focusing on an assignment. ADHD symptoms may cause them to miss social cues, increasing the likelihood of social friction. As a result, they often hear more criticism and correction than people who don’t have ADHD. This frequent criticism may seem like rejection of a sort, and it may contribute to feelings of shame and embarrassment that can trigger rejection sensitivity.

What’s more, hyperarousal in the brain can make it challenging for people with ADHD to differentiate smaller issues, like a phone call that wasn’t returned, from more significant types of rejection, like being dumped. Because of this, every instance of possible rejection, even a moderately raised voice, may seem more devastating and severe.

Long-term Effects of Rejection Sensitive Dysphoria

RSD isn’t an easy thing to live with. It can cause intense, overwhelming distress that individuals struggle to control.

Mistakes and rejection are both part of the human experience. A life without either doesn’t present much opportunity to learn or grow.

Furthermore, RSD can significantly affect quality of life, since people who fear rejection may end up avoiding all situations where it could occur. For example, they may not try to date or connect with others, even if they want to develop friendships or romantic relationships. They may stay in unfulfilling jobs because they fear getting rejected while applying for a new job or promotion. But over time, this behavior can cause feelings of frustration, dissatisfaction, or even depression.

People who respond to rejection sensitivity by trying to please everyone or developing perfectionist traits may experience frustration and distress when these measures don’t work. People pleasing can involve a loss or denial of the self, which can contribute to resentment. Mistakes and rejection are both part of the human experience. A life without either doesn’t present much opportunity to learn or grow.

Help for Rejection Sensitive Dysphoria

Rejection does hurt, but this pain is generally not permanent. It can also be helpful to address it in the moment by talking over the situation with the other people involved. Explicit communication can help individuals figure out when rejection is truly intended and when it is a misunderstanding.

For example, it can help to try asking a friend, “Why didn’t you return any of my text messages? I tried to get in touch with you all night. We were supposed to hang out!”

They may respond by saying, “Oh, I’m so sorry. I dropped my phone in the sink and couldn’t use it at all. Let’s hang out tomorrow instead.”

If an individual suspects they have RSD, they may want to see a mental health professional. Since RSD can resemble other mental health issues, it is important to get the correct diagnosis so that an individual gets the right treatment. Someone with bipolar will likely need a much different intervention than someone with ADHD-based rejection sensitivity.

Therapy can help individuals recognize when their RSD has been triggered. A therapist can help individuals reduce their overall stress and manage their perfectionist tendencies. Addressing these issues can make RSD episodes less frequent.

RSD often triggers an extreme response in the body’s HPA-axis, which controls the body’s stress hormone cortisol. Thus, some people use medication to address the biological aspect of RSD. Guanfacine, which is often prescribed for hyperactivity, is one of the more common medications used to address RSD. However, side effects such as sedation may make some individuals reluctant to take medication.

Would you like to learn more about rejection sensitive dysphoria? Find a qualified mental health professional today.

References:

1. Dodson W. (2019, November 26). Could you have rejection sensitive dysphoria? ADDitude. Retrieved from https://www.additudemag.com/rejection-sensitive-dysphoria-adhd-symptom-test/
2. Dodson, W. W. (2016). Emotional regulation. Attention. Retrieved from https://chadd.org/wp-content/uploads/2016/10/ATTN_10_16_EmotionalRegulation.pdf
3. Rejection can be more painful with ADHD. (2019, April 4). ADHD Weekly. Retrieved from https://chadd.org/adhd-weekly/rejection-can-more-painful-with-adhd
4. Rejection sensitive dysphoria: What is it and how to deal with it. (2018, April 8). Retrieved from https://www.depressionalliance.org/blog/2018/04/08/rejection-sensitive-dysphoria
5. Zimmer-Gembeck, M. J., & Nesdale, D. (2013). Anxious and angry rejection sensitivity, social withdrawal, and retribution in high and low ambiguous situations. Journal of Personality, 81(1). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22583003

Many people with attention-deficit hyperactivity (ADHD) learn to use various tools or other methods to compensate for the areas in which they struggle. Sometimes these methods can work well. They are often a great asset that has limited consequences.

But in some situations, people may use tools or methods at the expense of efficiency. A long history of struggling may lead to the development of systems that are also geared toward reducing the anxiety that stems from a fear of making mistakes or disappointing people. When underlying weaknesses in executive functioning are paired with anxiety, it can be especially tough to let go of non-efficient tools and be successful with implementing new ones. This is often the case even in spite of any issues a person has with efficiency.

Consider this fictional case example. Joe, a 45-year-old male, has struggled with inattention, time management, organization, and other issues since he was a child. He was not formally diagnosed with ADHD until his late twenties. At that point, he began taking medication. Only in the past two years has Joe begun participating in psychotherapy and ADHD coaching to gain practical tools to better manage his symptoms.

When underlying weaknesses in executive functioning are paired with anxiety, it can be especially tough to let go of non-efficient tools and be successful with implementing new ones.

Joe works in a company where he has to manage several employees, delegate tasks, and write reports based on data analysis that he completes regarding revenue from different branches of the company. He is generally on top of things but spends considerable extra time double-checking with each employee to ensure he provided them with given tasks and assistance planning how they should complete each task. In addition, Joe uses up countless hours manually inputting information into his own charts and tables so he can understand things before he runs any analyses.

The main problem Joe experiences is this: As a result of struggling to remain on top of things for many years, he uses systems to ensure that he does so now. However, his methods are not efficient. As a result, his boss is beginning to complain about his speed of completing tasks. However, Joe is very hesitant to make any significant changes to his systems. He fears he will not be able to be successful at following the necessary steps and will likely make more mistakes by trying to do so.

For Joe, and many people in similar situations, figuring out what changes to make and how to adjust to them can be difficult. The follow suggestions on how to navigate making changes in existing systems may help you be more efficient—without letting anxiety impede your ability to follow through with the changes.

1. Identify benefits and drawbacks of particular systems and methods. 

Taking the time to consider whether systems or methods are helping you or having a negative impact. These systems might include task lists, methods for managing staff, time sheets or other devices that track accountability to others, outlines, and charts, among others. You might find some of these to be helpful, but others may slow you down and be more cumbersome than anything else.

If a particular system slows down your completion of a task, you may wish to consider how helpful it is to continue with it. Consider the benefits of each system. If a system offers some benefit but is difficult to use, you might consider whether a suitable alternative might cut down on preparation time. There may be a simpler task list, for example, or an automated system for reminding staff of specific items.

2. Strive to alter systems rather than completely overhauling them. 

This will limit the impact that weaknesses in executive functioning and anxiety have on adjustment to a new system. If something, or part of something, is working for you, it can be helpful to consider what about it works and keep using that, if possible.

3. Transition to a new system by temporarily using both the old system and the new. 

This can be helpful in many cases by helping you reduce and manage the anxiety you may experience when switching to a new system. If you are switching from a whiteboard to-do list to an electronic one such as gTasks, it may be helpful to keep using the whiteboard and duplicating things on gTasks initially. If it turns out that a new system does not work as well as expected, you can easily switch back to the existing system.

It may be a good idea to block out extra time to devote to tasks when trying out new systems. If you are changing how you organize information (by making fewer charts or diagrams, for example), mentally prepare to feel nervous as you engage in a familiar task without the comfort of as many preparation steps as you’re used to. In some instances, tolerating being anxious can help you realize you did not actually need all the preparation steps you used in the past. You might make some mistakes as a result of adjusting your systems or using fewer steps. This is normal. But when it occurs, it’s important to have tools for readjustment in place.

This list is certainly not exhaustive of things you can do to help yourself make adjustments. But hopefully it will get you thinking about possibilities you might take action on.

Joe was able to simplify staff management by using an electronic task list that allowed him to delegate tasks with one click and easily see who was working on each item. He was also able to automate reminders for staff check-ins and use Google forms to synthesize information about updates from staff. In addition, Joe began to use some automated tables and charts, annotating them to better understand the information before analyzing it. This saved him hours of work per project. There were some instances along the way where using fewer steps led to minor mistakes. However, Joe was able to tolerate that as he fine-tuned his approach. When necessary, he used older systems to double-check things as he phased them out.

If you’d like help with ADHD symptoms or want to explore possible strategies for improved efficiency, consider reaching out to a therapist or counselor. Mental health professionals trained in helping people manage ADHD can offer beneficial support and guidance.  

When you have attention-deficit hyperactivity, managing the demands of adult life—working, paying bills on time, completing necessary tasks, and so on—can be enough of a challenge when you only have to take care of yourself. If you are a parent, the added responsibility of a child or multiple children can add to the potential for chaos.

What happens when the second parent also has ADHD? Is this a recipe for disaster? It certainly doesn’t have to be. Two parents with ADHD have the full ability to parent well and thrive by recognizing potential areas of difficulty, taking preemptive steps to navigate them, and exploring ways to become more organized.

Here are several suggestions that can help you keep track of the many parenting considerations you navigate on a daily basis. These ideas may make it easier to keep things running smoothly in your home.

• Have clear guidelines on which parent is responsible for which things (always, or on specific days) and have these written down for easy reference. Does one parent make the lunches each night? Is the parent who gets home the one responsible for cooking dinner? Which parent goes grocery shopping each week? [fat_widget_right]
• For less common occurrences such as sports practices, after-school activities, and so on, make sure it is clear which parent is responsible for dropping off and picking up the kids.
• Look at your work calendar and any other calendars you have to ensure you do not have conflicts that impact your ability to drop off, pick up, or otherwise be available for childcare-related responsibilities when you are needed.
• Set weekly or biweekly meetings to review the schedule in order to catch any conflicts with pre-planned responsibilities or discuss any challenges that arise. Maybe one of you really hates making lunches and would be happy to do another task instead. Communication is key!

When it comes to shared parenting-related responsibilities, specific tools may help you keep track more effectively. Consider the following:

• A joint calendar can show all activities and notes about who is responsible for dropping off and picking up the kids. If specific items (baseball bag, violin) are needed, add those in the notes section or use a notification to remind the parent to pack that item. The Family calendar on Apple Devices is often a good option because it provides a notification when a new event has been added. Another good option might be creating a shared Google account with a calendar.
• A shared task list can be immensely helpful. Having one list for responsibilities shared between parents and another list for each parent’s responsibilities is often useful. What’s important is that all three task lists can be viewed and edited by both parents. This lets both parents see what they need to do and add tasks for the other parent if needed. This can be helpful if you have a hard time remembering to tell your partner things that need to get done. This is also a good way for parents who are divorced to share information easily. The Reminders App and Wunderlist are good options for this. GTasks is another good option, but most task list apps would work, as long as they allow lists to be shared with others.
• Apps that track feedings, diaper changes, and naps can be helpful for parents of infants and toddlers. These apps ensure the necessary information is communicated between parents. Baby Tracker and Daily Connect are good options for tracking this type of information.
• A kitchen whiteboard or something similar can help keep track of tasks. Depending on what needs to be kept track of and how tech-savvy you both are, sometimes it’s helpful to have a “hard copy” of the task list at home. The benefit of this type of system is that it is easily viewable at home. It does have downsides: It isn’t portable, and there aren’t any reminders or notifications!

This list of suggestions is not exhaustive. However, I hope it has given you some useful tools—or ideas, at the very least—for keeping track of parenting responsibilities more easily.

If you’re a parent, you have to keep track of many responsibilities and tasks, whether you have ADHD or not. Having ADHD can make parenting more challenging, but it doesn’t have to cause difficulty. If you’d like to further explore parenting with ADHD or believe the support of a therapist or counselor may be beneficial, I encourage you to reach out and seek help today.

What do you consider an optimal work-life balance? People may have slightly different views on what an “ideal” work-life balance is for them, but there is a general consensus, from medical and mental health professionals alike, that maintaining this balance is important to overall well-being.

In today’s society, it is often difficult to achieve this ideal balance between professional and personal life. For those who experience symptoms of ADHD, it may be even harder. More specifically, individuals with ADHD may find it challenging to keep up with their workload in addition to aspects of their personal life. They may often feel as if they are always trying to play catch-up, or merely trying to stay afloat, as they attempt to get things done. A lack of downtime, or anxiety about not getting anything done during downtime, may impede enjoyment of life and prevent people from feeling successful about the things they have been able to complete.

Furthermore, many people who have ADHD use tools to help them cope with their symptoms. While these tools are often extremely helpful, they may increase the amount of time needed to complete various tasks. For example, it may take extra time to set up an app or calendar to get and stay organized before completing a particular task or tasks.

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Another common dilemma some may experience while striving to obtain an optimal work-life balance is whether it’s better to work longer hours in order to stay organized and on top of work tasks or work more standard hours and have more personal time but potentially be less effective or successful at work. The answer to this question is likely to depend on each person, along with a number of other factors.

The following suggestions can help everyone, especially people who experience symptoms of ADHD, take steps toward achieving their ideal work-life balance.

1. Identify your optimal work-life balance. 

Does this mean you work longer hours at the office if needed but never take work home? Does it mean you never respond to work emails over the weekend? Does it mean you leave work early twice a week to coach your child’s team and work later on certain nights to make up for it? Identifying solutions that are ideal for you can help you begin taking steps to achieve them.

2. To the extent that is possible, choose a job that interests you and plays to your strengths.

If you frequently have new ideas but struggle with doing the same thing over and over again, you might consider a job where each day is different and you don’t sit behind a desk all day. If you struggle with small details, a position that does not require you to complete highly detailed projects may be ideal. If you find it hard to work under pressure and it takes you a long time to complete specific tasks, especially on deadline, you may want to avoid private sector jobs where you would be penalized for billing too many hours, and so on.

3. Consider the impact your mental health can have. 

Anxiety can often co-occur with ADHD, especially in relation to work and home life. If you are anxious about getting all of your work done and balancing things at home, you are likely to be even less successful in both places. Thus, taking charge of any anxiety, and taking steps to address it, is an important aspect of work-life balance. Using tools to prioritize time more effectively can often help. Delegating more (when feasible) is another helpful strategy. It’s possible to take some steps individually, but it is also encouraged to seek support from a professional, such as a therapist or coach, when working on developing these types of skills.

Depression can also frequently occur with ADHD, especially after prolonged periods of difficulty at work and home. Developing the ability to be more on top of work tasks and personal goals and needs may help reduce symptoms, but it is often difficult to minimize depression symptoms without professional help. With the support of a trained and compassionate counselor, you can begin learning strategies to reframe negative thoughts and better understand any underlying issues and conflicts. In some cases, therapists may also refer a person for medication, when such an intervention may be helpful.

This list is not exhaustive. It is simply intended to get you thinking about your optimal work-life balance and factors (ADHD as well as others) that could be inhibiting it. Once you have considered these things, you may find it easier to begin taking action to improve your work-life balance and take care of all of your needs.

If you are not happy with your current work-life situation, I encourage you to begin making what changes you can on your own. The support of a mental health professional can also be greatly beneficial as you figure out how to make your aspirations a reality in order to obtain as much satisfaction from life as you possibly can.

References:

1. Jans, T., & Jacob, C. (2013). ADHD in families. In Surman C. (Ed.) ADHD in adults: A practical guide to evaluation and management (161-190). Totowa, NJ, Humana Press.
2. Tejera, V. A. (2014). Work-life balance issues among mental health professionals capstone. MOJ Public Health, 1(1): 00005. Retrieved from http://medcraveonline.com/MOJPH/MOJPH-01-00005.php

In any relationship, there may be struggles with communication, expectations, and unmet needs. For relationships in which at least one of the partners has attention-deficit hyperactivity, better known as ADHD, these struggles can be pronounced. Because ADHD impacts brain functioning and behavior, all aspects of life may be impacted by the symptoms—positively and negatively.

There are numerous potential benefits to being in a relationship with someone with ADHD. People with ADHD tend to be creative and passionate, among many other desirable attributes. There are also challenges that come with loving and living with someone with ADHD that often go unnoticed and therefore unaddressed. The more awareness you have of how symptoms can impact a relationship, the more prepared you may be to manage the challenges that come your way. These may include:

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1. Impulsivity

What this can look like in your relationship: Impulsivity can manifest as, for example, moving in too quickly with your partner or making other major decisions around the relationship with little thought or preparation (but, perhaps, with plenty of love and good intention). Because someone with ADHD may be lacking in stimulation in their prefrontal cortex, they may seek it in ways large and small. This can also play out in the person with ADHD making blunt comments that could unintentionally hurt their partner’s feelings.

The need for stimulation is high for those with ADHD. When they find something that makes them feel good, typically they want to chase that feeling. Examples of this may include binging on a Netflix series, playing a video game for extended periods, or, if their job is interesting enough to them, overly investing in work. In a relationship context, they may want to do exciting (and perhaps unsafe or unwise) or last-minute activities together.

2. Communication

What this can look like in your relationship: For some individuals with ADHD, arguing and continuing conflict may be a common theme in their relationship—not necessarily because they’re unhappy in the relationship, but because, for some, it feels good to engage, even through arguing. For the other partner, this can be infuriating and exhausting to be a part of.

On the other hand, some individuals with ADHD who aren’t stimulated by conflict have the opposite experience in arguments. For example, they may get stuck and struggle to communicate or advocate for themselves on the spot. As the other partner, you may find this frustrating and wind up concluding, inaccurately, they don’t care enough to engage and fight for the relationship.

You are not crazy, and you are not alone. You are, however, in a relationship that may need extra care, patience, consideration, and communication.

3. Forgetfulness

What this can look like in your relationship: This one’s pretty straightforward. Forgetfulness can manifest in all kinds of frustrating ways in a relationship: losing the car keys, forgetting about a scheduled date, forgetting to do something their partner asked them to do, paying bills late, leaving the stove on, and the list goes on.

ADHD makes it easy to get sidetracked. It can have nothing to do with how much the person loves or cares about their partner and their needs. It has everything to do with a condition that takes the person out of the moment, no matter how much they may want to stay in it.

4. Struggles with Organization

What this can look like in your relationship: Are there unfinished projects in the home? Is the home overly cluttered or dirty? It may be difficult for a person with ADHD to stick with and complete one task at a time, whether it’s organizing the basement, painting the kitchen, or something else. Other ways organizational struggles can play out: the person with ADHD can’t find their favorite sweatshirt, often misplaces their glasses, or inconsistently handles household tasks. Perhaps the person successfully installs the screen door, but then leaves all the tools they used for the project out on display for weeks until you ask them (possibly multiple times) to put them away.

A person with ADHD may find their struggles with organization every bit as frustrating as their partner, if not more so.

5. Distraction

What this can look like in your relationship: Do you often feel like you have to repeat yourself to your partner with ADHD? Do you catch them seemingly not listening to you? Do you get angry after asking them to pick up an item at the store or do a certain task and after multiple requests they still haven’t done it? Do you experience conversations with your partner constantly taking detours (i.e., you start one topic and quickly end up on a different topic)?

Some of these examples, as applicable as they may be to your relationship, may feel a bit overwhelming. The intention here is to give you some insight and awareness into your everyday experiences with a partner whose condition may have no apparent cause while having very apparent effects on your relationship. You are not crazy, and you are not alone. You are, however, in a relationship that may need extra care, patience, consideration, and communication. Although medication can be helpful, a person with ADHD cannot will themselves into being “better,” and they can’t simply think their way into, say, focusing more or calming down.

Talk with your partner about your expectations and needs and how to go about getting them met in a reasonable, realistic way. It’s important to develop a plan. Meeting with a couples therapist who has experience working with ADHD is a great place to start.

Fidget spinners, toys that allow people to quietly fidget by spinning a device, are surging in popularity. Many companies market these toys as relievers for stress and anxiety. They hold the 16 top spots in Amazon’s toy rankings. Together with fidget cubes, the toys occupy more than 40 of the top 50 spots.

As with many toy trends, some adults have responded with frustration, derision, and even paranoia. A false story recently circulating on Facebook claimed fidget spinners could disrupt Earth’s center of gravity.

Proponents of the toy say it could help people with attention deficit hyperactivity (ADHD), autism, or anxiety by offering a focused outlet for their energy. Some schools even allow students to use fidget spinners to help them concentrate. Experts, however, note a lack of research on any link between fidget spinners and ADHD symptoms. Rather than assuming the toys will work for alleviating symptoms of ADHD, experts recommend that parents seek research-backed treatment options.

Experts also say there is no reason to worry that fidget spinners are harmful. There’s little evidence that any single toy changes behavior or cultural beliefs.

Dual Gait Testing as Early Predictor of Dementia

[fat_widget_right]Observing a person’s gait while they perform a cognitively taxing task can provide early evidence of dementia. The process, known as dual gait testing, may predict dementia in people with memory issues. According to the study, people with mild cognitive impairment whose motion slows down by about 20% while performing the cognitive task may be at an increased risk of developing dementia.

Why You Should Quit Chasing Happiness and Pursue Meaning Instead

According to a new book, The Power of Meaning: Crafting a Life That Matters, the pursuit of happiness might undermine its achievement. Meaning is what makes life worth living, the book’s author argues. Pursuing happiness as its own goal may be a distraction from the sense of purpose that is more likely to help people feel happier.

Bouldering Envisioned as a New Treatment for Depression

Bouldering, a popular form of rock climbing, may ease symptoms of depression. The authors of a new study say people who began bouldering three hours a week for eight weeks saw reductions in depression. They suggest the physical, cognitive, and social components of the sport may help. People may boulder with friends, and bouldering poses both physical and intellectual challenges.

Can Parents’ Tech Obsessions Contribute to a Child’s Bad Behavior?

Increased reliance on technology may undermine parents’ relationships with their children. According to a study that looked at surveys completed by mothers and fathers in 170 households, half of parents said technology disrupts time with their children. On average, technology interrupts parent-child interactions two to three times per day. The study suggests these interruptions may be associated with increased behavior problems from children.

Suit: SC Mental Health Needlessly Hospitalizes People

In a federal class action lawsuit, Protection and Advocacy for People with Disabilities—a disability advocacy organization—alleges that the South Carolina Department of Mental Health is unnecessarily hospitalizing people with mental health issues. A 1999 U.S. Supreme Court decision in Olmstead v. L.C. found people with mental health disabilities have a right to live in less restrictive settings. Thus, needless hospitalization or institutionalization is a form of mental health discrimination.

Meditation May Cause Negative Feelings for Some, Study Finds

Research links meditation to numerous benefits, including improvements in mental health. However, research that includes interviews with nearly 100 meditation teachers and meditators suggests it may not be positive for everyone. Some people who meditated reported side effects such as insomnia, sensitivity to light or sound, anxiety, or panic.