ADHD’s Knock-On Effects On Mental Health

We’ve written before about ADHD in adult life, often late-diagnosed because it’s not quite what people think it is:

ADHD… As An Adult?

In women in particular, it can get missed and/or misdiagnosed:

Miss Diagnosis: Anxiety, ADHD, & Women

…but what we’re really here to talk about today is:

It’s the comorbidities that get you

When it comes to physical health conditions:

• if you have one serious condition, it will (usually) be taken seriously
• if you have two, they will still be taken seriously, but people (friends and family members, as well as yes, medical professionals) will start to back off, as it starts to get too complicated for comfort
• if you have three, people will think you are making at least one of them up for attention now
• if you have more than three, you are considered a hypochondriac and pathological liar

Yet, the reality is: having one serious condition increases your chances of having others, and this chance-increasing feature compounds with each extra condition.

Illustrative example: you have fibromyalgia (ouch) which makes it difficult for you to exercise much, shop around when grocery shopping, and do much cooking at home. You do your best, but your diet slips and it’s hard to care when you just want the pain to stop; you put on some weight, and get diagnosed with metabolic syndrome, which in time becomes diabetes with high cardiovascular risk factors. Your diabetes is immunocompromising; you get COVID and find it’s now Long COVID, which brings about Chronic Fatigue Syndrome, when you barely had the spoons to function in the first place. At this point you’ve lost count of conditions and are just trying to get through the day.

If this is you, by the way, we hope at least something in the following might ease things for you a bit:

• Stop Pain Spreading
• Managing Chronic Pain (Realistically!)
• Eat To Beat Chronic Fatigue (While Having The Limitations Of Chronic Fatigue)
• When Painkillers Aren’t Helping, These Things Might
• The 7 Approaches To Pain Management

It’s the same for mental health

In the case of ADHD as a common starting point (because it’s quite common, may or may not be diagnosed until later in life, and doesn’t require any external cause to appear), it is very common that it will lead to anxiety and/or depression, to the point that it’s perhaps more common to also have one or more of them than not, if you have ADHD.

(Of course, anxiety and/or depression can both pop up for completely unrelated reasons too, and those reasons may be physiological, environmental, or a combination of the above).

Why?

Because all the good advice that goes for good mental health (and/or life in general), gets harder to actuate when one had ADHD.

• “Strong habits are the core of a good life”, but good luck with that if your brain doesn’t register dopamine in the same way as most people’s do, making intentional habit-forming harder on a physiological level.
• “Plan things carefully and stick to the plan”, but good luck with that if you are neurologically impeded from forming plans.
• “Just do it”, but oops you have the tendency-to-overcommitment disorder and now you are seriously overwhelmed with all the things you tried to do, when each of them alone were already going to be a challenge.

Overwhelm and breakdown are almost inevitable.

And when they happen, chances are you will alienate people, and/or simply alienate yourself. You will hide away, you will avoid inflicting yourself on others, you will brood alone in frustration—or distract yourself with something mind-numbing.

Before you know it, you’re too anxious to try to do things with other people or generally show your face to the world (because how will they react, and won’t you just mess things up anyway?), and/or too depressed to leave your depression-lair (because maybe if you keep playing Kingdom Vegetables 2, you can find a crumb of dopamine somewhere).

What to do about it

How to tackle the many-headed beast? By the heads! With your eyes open. Recognize and acknowledge each of the heads; you can’t beat those heads by sticking your own in the sand.

Also, get help. Those words are often used to mean therapy, but in this case we mean, any help. Enlist your partner or close friend as your support in your mental health journey. Enlist a cleaner as your support in taking that one thing off your plate, if that’s an option and a relevant thing for you. Set low but meaningful goals for deciding what constitutes “good enough” for each life area. Decide in advance what you can safely half-ass, and what things in life truly require your whole ass.

Here’s a good starting point for that kind of thing:

When You Know What You “Should” Do (But Knowing Isn’t The Problem)

And this is an excellent way to “get the ball rolling” if you’re already in a bit of a prison of your own making:

Behavioral Activation Against Depression & Anxiety

If things are already bad, then you might also consider:

• How To Set Anxiety Aside and
• The Mental Health First-Aid That You’ll Hopefully Never Need ← this is about getting out of depression

And if things are truly at the worst they can possibly be, then:

How To Stay Alive (When You Really Don’t Want To)

Take care!

There are many personality-typing systems that, with varying degrees of validity*, aim to describe a person’s personality.

*and often pseudoscience:

• sometimes obviously so like astrology
• sometimes dressed up in clinical words like the Meyers-Briggs
• sometimes openly, per “this is not science but you may find it useful to frame things this way”, like the Enneagram

There is currently one kind of personality-typing system (with some minor variations) that is used in the actual field of clinical psychology, specifically under the umbrella of “trait theory”, and that is…

The “Big Five” personality traits

Also called the OCEAN or CANOE model, based on its 5 components:

• openness to experience: inventive/curious rather than consistent/cautious
• conscientiousness: efficient/organized rather than extravagant/careless
• extroversion: outgoing/energetic rather than solitary/reserved
• agreeableness: friendly/compassionate rather than critical/judgmental
• neuroticism: sensitive/nervous rather than resilient/confident

The latter (neuroticism) is not to be confused with neurosis, which is very different and beyond the scope of today’s article.

Note that some of these seem more positive/negative than others at a glance, but really, any of these could be a virtue or a vice depending on specifics or extremity.

For scientific reference, here’s an example paper:

The Big Five Personality Factors and Personal Values

Quick self-assessment

There are of course many lengthy questionnaires for this, but in the interests of expediency:

Take a moment to rate yourself as honestly as you can, on a scale of 1–10, for each of those components, with 10 being highest for the named trait.

For example, this writer gives herself: O7, C6, E3, A8, N2 (in other words I’d say I’m fairly open, moderately conscientious, on the reserved side, quite agreeable, and quite resilient)

Now, put your rating aside (in your phone’s notes app is fine, if you hadn’t written it down already) and forget about it for the moment, because we want you to do the next exercise from scratch.

Who would you be, at your best?

Now imagine your perfect idealized self, the best you could ever be, with no constraints.

Take a moment to rate your idealized self’s personality, on a scale of 1–10, for each of those components, with 10 being highest for the named trait.

For example, this writer picks: O9, C10, E5, A8, N1.

Maybe this, or maybe your own idealized self’s personality, will surprise you. That some traits might already be perfect for you already; others might just be nudged a little here or there; maybe there’s some big change you’d like. Chances are you didn’t go for a string of 10s or 1s (though if you did, you do you; there are no wrong answers here as this one is about your preferences).

We become who we practice being

There are some aspects of personality that can naturally change with age. For example:

• confidence/resilience will usually gradually increase with age due to life experience (politely overlook teenagers’ bravado; they are usually a bundle of nerves inside, resulting in the overcompensatory displays of confidence)
• openness to experience may decrease with age, as we can get into a rut of thinking/acting a certain way, and/or simply consciously decide that our position on something is already complete and does not need revision.

But, we can decide for ourselves how to nudge our “Big Five” traits, for example:

1. We can make a point of seeking out new experiences, and considering new ideas, or develop strategies for reining ourselves in
2. We can use systems to improve our organization, or go out of our way to introduce a little well-placed chaos
3. We can “put ourselves out there” socially, or make the decision to decline more social invitations because we simply don’t want to
4. We can make a habit of thinking kindly of others and ourselves, or we can consciously detach ourselves and look on the cynical side more
5. We can build on our strengths and eliminate our weaknesses, or lean into uncomfortable emotions

Some of those may provoke a “why would anyone want to…?” response, but the truth is we are all different. An artist and a police officer may have very different goals for who they want to be as a person, for example.

Interventions to change personality can and do work:

A systematic review of personality trait change through intervention

There are many ways to go about “being the change we want to see” in ourselves, and yes there can be a degree of “fake it until you make it” if that works for you, but it doesn’t have to be so. It can also simply be a matter of setting yourself reminders about the things that are most important to you.

Writer’s example: pinned above my digital workspace I have a note from my late beloved, written just under a week before death. The final line reads, “keep being the good person that you are” (on a human level, the whole note is uplifting and soothing to me and makes me smile and remember the love we shared; or to put it in clinical terms, it promotes high agreeableness, low neuroticism).

Other examples could be a daily practice of gratitude (promotes lower neuroticism), or going out of your way to speak to your neighbors (promotes higher extraversion), signing up for a new educational course (promotes higher openness) or downloading a budgeting app (promotes higher conscientiousness).

In short: be the person you want to be, and be that person deliberately, because you can.

Some resources that may help for each of the 5 traits:

1. Curiosity Kills The Neurodegeneration
2. How (And Why) To Train Your Pre-Frontal Cortex
3. How To Beat Loneliness & Isolation
4. Optimism Seriously Increases Longevity!
5. Building Psychological Resilience (Without Undue Hardship)

Take care!