Tips from an ADHD Coach: When life throws you off your routine

People with ADHD can benefit from having routines and systems that help them cope. But, what happens when life comes into play and throws that routine off?

This week on Tips from an ADHD Coach, Jaye talks about what can happen when we get thrown off our game by special life circumstances like getting sick or moving. Listen for some tips that can help get you back on track.

Have a challenge you’d like Jaye to talk about in an episode? Email or send a voice memo to us at adhdcoachtips@understood.org.

Related resources

• ADHD and hormones (Cate Osborn’s story)

Timestamps

(00:51) Cate’s quote

(02:39) ADHD and hormones

(03:58) “Exception moments,” or temporary states when our life is a bit different than usual

(06:15) How can we help ourselves during these periods?

(11:29) Recap

Episode transcript

Jaye: Do you have a routine or system that works for you? Does following that routine or system make it easier to do the things you need to get done? What happens when something disrupts that routine or system? Does that disruption throw everything off?

This is "Tips from an ADHD Coach," and I'm your coach, Jaye Lin. Today we're talking about how with ADHD we can sometimes get thrown off our game when there are changes in our lives and how those changes can cause a domino effect in our productivity and confidence. We're going to hear from Cate, who before she became the host of "Sorry, I Missed This" on this channel, was on another Understood.org podcast, "ADHD Aha!," about a time in her life when she just wasn't able to function at her normal capacity.

(00:51) Cate's quote

Cate: So, basically I had a cyst on my right ovary and the cyst got so large that the weight of it basically pulled my ovary, like around itself, inside my body, and the circulation to that ovary got cut off. And it's a very serious medical emergency. So, I had an ovarian torsion and things started to happen in my brain that were just very confusing.

I'm an actor and a performer, and so at the time, I was working at a Shakespeare company and we were doing three shows in rep and I'm, the hair flip, very good at my job. And so, I had some like big deal parts in the company, you know, so it's kind of a big deal. I'm pretty fancy. And so, I would sit down to try and memorize my lines and I just, I couldn't do it. And I love Shakespeare. Shakespeare is my, like, hyperfixation. And I couldn't memorize my dang lines.

And then, like slowly, like other stuff started to happen as well. Like, I noticed that I would just forget more things. I would lose my phone, I would lose my keys. My house was a mess. Like, I had to hire professional organizers to come in and dig me out of the hole that I had put myself in. And it was really scary.

And at the time I thought that I had early-onset dementia and it kind of came to a head one night. It was like two weeks before the show. Our first show was supposed to open and I didn't have my lines. My personal and my professional reputation are on the line.

And so, I was like having my husband quiz me on my lines. I remember very specifically, he looked at me and he was like, "Are you OK? You are never this bad. You are never this bad on your lines." And I couldn't retain information when I did find like the focus to like, sit down and learn my lines. I would just immediately get distracted. I wasn't holding information and I was like, "No, I'm not. I'm not OK."

(02:39) ADHD and hormones

Jaye: What Cate described was a serious life-threatening condition that led to surgery in order to remove an ovary, which can affect hormone levels. We know that changes in hormone levels affect how we experience the effects of ADHD and that when our estrogen is lower, like during menopause, perimenopause, and right before we get our periods, the dopamine transmission in our brains can be lower as well, which can amplify our ADHD symptoms.

This is a very short explanation of what happens with hormone changes. But Cate goes into detail with this process. So, if you want to know more about it, I highly recommend listening to Cate's "ADHD Aha!" episode or a recent "ADHD and" episode on hormones that Dr. Monica Johnson did on this channel. We'll have a link to both of those in our show notes.

So, after Cate's ovary removal surgery, her remaining ovary had to learn to catch up on hormone production and her dopamine levels were lower than normal. This made it harder for her to do the things she was used to doing more easily, like memorizing lines, keeping her home tidy, and keeping track of her belongings. I say more easily because even before this happened, she still had ADHD and struggled with organizing and keeping her room clean. But before the ovary removal, she was able to make it work.

(03:58) "Exception moments," or temporary states when our life is a bit different than usual

What Cate experienced after surgery was not the standard of how she normally goes through life. It was an exception, not the rule. She could recognize that her body and brain are not functioning the way she normally expects. And while that was happening, she was in what I call an exception moment.

And like I said before, these moments where we are not functioning normally can happen to us with other changes in hormones right before we get our period and in certain parts of perimenopause, menopause, puberty, etc.

Exception moments can also happen outside of hormone changes, like when we're in periods of burnout, after we have had an emotionally explosive event in our lives, when we're under a lot of stress, and when there are life events. We are sometimes not ourselves when we experience grief, big life changes like having a baby, moving to a new home, starting a new job, etc. In those moments, the weight of stress, lack of sleep, and emotional dysregulation can make it harder for us to function the way we normally do.

When these exception moments happen, it can bring up a range of emotion towards ourselves like frustration, disappointment, anger, and hopelessness. And since emotional dysregulation can be worse when we have lower levels of dopamine, the emotions we feel can seem even more devastating.

And to make this process even more cruel when we have negative associations about ourselves and negative emotions that feel overwhelming, it can be even harder to be productive because dopamine and motivating energy can often be driven by confidence in our abilities and positive associations we have with what we're doing.

So, while Cate's difficulty with memorizing her lines for the play were explained by hormone changes, the frustration she had of not being able to memorize her lines could have made it even harder for her to get those lines down. And that can create doubt about memorizing lines in the future, which can make it harder to produce results in the months and years to come.

For a lot of us with ADHD, when we lose that confidence in our abilities during exception periods, the doubt and loss of productivity can continue on even after we return to our normal capacity.

(06:15) How can we help ourselves during these periods?

So, what can we do when we find ourselves in this cycle of being in an exception period where our productivity and mental focus are lower than normal? How can we survive this period without falling into the trap of doubting our abilities in the future?

The first thing I suggest is to take a pause to reflect. Think about what in our lives is contributing to this exception period. Is this a permanent change or is it temporary? It's common for us to think that whatever is going on in the moment is our new normal and that it's going to be like this forever. But most of the time it's not.

Cate's remaining ovary had to learn to catch up on hormone production, and it's likely that her challenges with executive function and focus will continue to improve. The week before our period is going to be more difficult with ADHD challenges. But you know what happens two weeks later? We are typically at our best with executive function, emotional regulation, and focus because that's when we have the most estrogen in our system.

Even for things like perimenopause and menopause, which can go on for longer periods of time, there are moments when we are at our best and moments where it's more of a struggle. We can take comfort in knowing that an exception period is temporary and that we can believe in ourselves again fully after the exception moment is over. Next, we can accommodate the situation when we're in exception moments.

This will vary depending on the situation, but this can look like asking our loved ones to pitch in to help and communicating that we're in a downturn right now so that others can adjust their expectations, and we can adjust our own expectations. Cate did this by hiring a professional organizer to get her home in order. Adjusting expectations can look like doing less for a period of time, letting go of perfectionistic tendencies for a little bit, and prioritizing rest.

This is already something we do in drastic situations, like in moments of grief. Everyone expects us to take time off of work when a loved one passes and they don't expect us to function at our normal capacity. Expectations are lowered because everyone knows that in moments of grief, it's unrealistic for anyone to be expected to function normally. We can apply this to exception moments outside of grief as well, as long as it's being communicated to others.

We can also be proactive with communicating and adjusting our expectations. Sometimes these downturns can be predicted. I know that the week before my period comes, I'm going to function at lower capacity so I can plan to do a little more two weeks beforehand and plan to do a little less when that regular downturn happens.

In the two days after I get my Covid booster, I block out the whole weekend to rest and be unproductive because I know that I get fatigued and brain foggy after I get my booster. And the past few weeks, I've been pretty stressed moving from Washington to California. So, I communicated to my production team that I will likely be less productive than I normally am because I have a shortage of time and brain space. And also I might have to take my tiny dog who is having a hard time adjusting to my recording session.

Being able to anticipate downturns has the added benefit of allowing us to be more prepared when it does happen. We can do the executive functioning of figuring out what help we can get from others. We can make checklists for us to use instead of creating more executive function burden when the downturn happens.

We can even anticipate and communicate downturns when we have exception moments that are less drastic, like when we are about to go on vacation and we need to use a significant part of our workdays to hand over the work we're doing to others. We can communicate to our teams that we will have lower productivity in the week before our vacation when the handoffs need to happen and for them to expect less from us.

We can adjust expectations and make a plan of what we will do more or less of when our partners, co-parents, and roommates are out of town and we have to take on extra duties. And even the opposite of that, when we have friends and family members who come to stay with us, even to help. These are all disruptions to our routines and structure. And with executive dysfunction, it can be harder for us to adapt to changes that are thrown at us.

But they are fairly predictable and we can be better prepared when they do happen. In fact, all of it can be fairly predictable. We may not always know when exception moments will happen to us and when we will be at a lower capacity to be productive, but one thing we do know is that these exception moments will happen. And also it's extremely likely that exception moments will end and we will be back to our normal selves when they do.

We don't need to change our confidence in our abilities in general because these moments are the exception and not the rule. They too shall pass.

(11:29) Recap

We can have moments in our lives when our ADHD challenges can be more intense and we have lower executive function motivating energy, focus, and productivity. Hormonal changes, burnout, grief, emotional dysregulation, and life changes can often make us function very differently than normal, which can cause us to have negative emotions about ourselves, which can make being productive even harder and cause us to doubt our abilities.

This doubt can create even more difficulty with the task and our productivity going forward, even after the exception moment ends. But if we take a pause to recognize when an exception moment happens and acknowledge that it's temporary, we can have better results. We can communicate these exception moments to others, and adjust expectations for ourselves and even do this proactively.

Because while exception moments may not always be predictable, it's completely predictable that we will have exception moments in our lives. We don't have to create doubt in our abilities because these moments are exceptions and not the rule. And they too shall pass.

That's it for today. Thanks so much for listening. If you have a challenge you'd like me to talk about or would just like to say hi, you can email us at ADHDCoachTips@understood.org. You'll also find links to anything mentioned in the show and more resources in the description below. Make sure to subscribe to our channel for more content like this, and I hope to see you next time.

"Tips from an ADHD Coach" is produced and edited by Jessamine Molli and Margie DeSantis. Video is produced by Calvin Knie. Our theme music was written by Justin D. Wright, who also makes the show. Ash Beecher is our supervising producer, Briana Berry is our production director, and Neil Drumming is our editorial director. For Understood.org, our executive directors are Laura Key, Scott Cocchiere, and Seth Melnick. And I'm your host, Jaye Lin.