Planning with ADHD: The What, The When, and The How
By Joanna Harding-Duggan, B.A., Dip. C.S., PCC, ADHD/Wellness Coach
One of the most frequent challenges I hear in my coaching practice is not getting tasks or projects done in a timely, non-stressful manner. While there are many reasons for this, in my experience, it can basically be boiled down to challenges with the executive functions planning, prioritization, and task initiation. That is, knowing what is the most important thing to do, scheduling when to do it, and understanding how you will follow through with the task.
While reviewing some research I came across a study by Cortese et. al (2012) who completed a meta-analyses of task based functional MRI studies and found evidence of ADHD related challenges within multiple neuronal systems that involved higher level cognitive functions. What does this mean? It showed that while ADHD is manifested behaviourally, it is not representative of character flaws, but of neurochemical differences. Therefore, inability to follow through with the best laid plans or perhaps the inability to create that plan is not a function of laziness but in fact a function of brain based challenges.
Further evidence of the neurocognitive challenges underlaying ADHD is found in a study by Fuermaier et. al (2013) who explored complex prospective memory. They define prospective memory as the execution of delayed intentions in the future; elements of prospective memory were identified as planning, plan recall, self-initiation, and plan fidelity. Difficulties with prospective memory were found to be due to planning deficits, with the following therapeutic implications “... clinicians are advised to focus on elaborate and careful planning of delayed intentions in order to induce reliable behavioral changes in the treatment of patients with ADHD” (Fuermaier et. al 2013). In other words, execution of intentions requires strategic planning.
When we overlay the ability to plan with the various dimensions of wellness we can see how it can significantly impact multiple areas of life.
Occupational Well-Being:
Poor planning in the work place can result in working on the tasks you “feel” like doing as opposed to the ones that take top priority. Consequently a day is easily filled being pulled from one task to the next without any particular direction. As a result, you may feel like you are constantly behind or not on top of projects. This can contribute to burn out, as well as feelings of overwhelm and exhaustion, which in turn affects sleep and well-being further exacerbating the executive functioning challenges associated with ADHD.
Financial Well-Being:
Challenges with planning and finances may result in bills not being paid on time, overspending, or an inability to manage more complex financial tasks such as paying taxes. These difficulties can lead to feelings of worry, inadequacy, fear, and shame. Avoidance is often a result which subsequently feeds into the challenge of financial management.
Academic Well-Being:
Higher education demands an ability to plan and manage multiple deadlines. Challenges in this area can result in not finishing assignments on time and/or being unprepared for exams and tests. This can lead to constantly feeling behind which in some cases results in avoidance and can put academic standing in jeopardy. Resultant feelings of exhaustion, overwhelm, and shame are all too common.
Physical Well-Being:
For too many people, physical wellness falls low on the priority list when life feels overwhelming. As a result you may not make time to engage in exercise or wellness activities or schedule needed appointments with doctors or other health care practitioners. As physical well-being is foundational for both mental and cognitive functioning, a direct negative impact on the management of daily life is commonly experienced.
So how do we remedy these challenges? How then can we support these prioritization, planning and task-initiation challenges? This is what I call The What, The When, and The How.
The What
Start with determining what it is you need to do. Create a list, preferably with pen and paper, then use a tool such as the Eisenhower matrix to help you determine the most urgent and important things that need to be done in the coming week (Eisenhower Matrix). Be mindful when creating the to do list of whether or not the items on the list are a “one and done”, such as making a dentist appointment, or need to be broken down into smaller chunks, such as paying taxes. Once items are in manageable chunks they can be appropriately scheduled.
The When
While I believe monthly, weekly, and daily planning are important, I will just address weekly planning here. Figure out what day of the week works best to sit down and plan. This is the time when you will take the urgent and important items from your to do list and determine when you are going to do them. For this I often suggest my blocked calendar system to clients (see example below). With this system the day is divided into three time blocks (using whatever division of the day makes sense to you) and tasks are planned into blocks. I like this system as if offers flexibility. I find that when tasks are planned to time (e.g. call dentist at 10am) and they don’t get done at that exact time, they tend not to get done at all. With the blocked calendar tasks are not tightly time bound. The rule with this system is if something is not done in the assigned block it is moved to another block but never taken off the schedule.
The How
This is often the most challenging part of planning – the follow through. There are a myriad of reasons why following through with planning is difficult and I don’t presume to know them all but, in my experience, follow through is frequently challenged when a task is boring, overwhelming, or difficult. The following are some strategies that can help:
·Determine what time of day works best for you and plan accordingly. Do you focus best in the morning, or perhaps afternoon is the time when your brain best engages in tasks?
·Make sure the task is broken down into small enough chunks. If it still feels overwhelming break it down some more.
·Use a strategy such as the Pomodoro (Pomodoro Technique) to help make your work feel more accessible by tackling it in small chunks of time with built in breaks.
·Create a pleasant atmosphere to work in. Make a coffee or cup of tea, play music (no lyrics), make sure your clothing is comfortable, and the lighting is adequate.
·When focus is an issue, it can be helpful to work out before tackling a difficult task, thereby naturally engaging the brain’s neurochemistry.
·Finally, it can help to have a work buddy or study buddy. Working with others in the room can help with focus and attention.
Finally, if you struggle with ADHD and would like help reach out to a coach or therapist please see the links below.
Center for ADHD Awareness Canada
Joanna Harding-Duggan is an ADHD/Wellness Coach who is committed to helping people make positive lifestyle changes that support physical and mental health. If you are interested in understanding your unique challenges, and developing strategies and action plans, book a Complimentary Consultation with her to find out how coaching can support you.
References:
Cortese, S., Kelly, C., Chabernaud, C., Proal, E., Martino, A., Milham, M., & Castellanos, F. (2012). Toward systems neuroscience of ADHD: a meta-analysis of 55 fMRI studies.
The American Journal of Psychiatry, 169 10, 1038-55 .https://doi.org/10.1176/appi.ajp.2012.11101521.
Fuermaier, A., Tucha, L., Koerts, J., Aschenbrenner, S., Westermann, C., Weisbrod, M., Lange, K., & Tucha, O. (2013). Complex Prospective Memory in Adults with Attention Deficit Hyperactivity Disorder. PLoS ONE, 8. https://doi.org/10.1371/journal.pone.0058338.