Do you or a loved one get distracted easily? Do you notice a chronic behaviors such as distractibility, difficulty with attention to detail, forgetfulness, restlessness, or impulsivity? If so, ADHD–Attention-Deficit/Hyperactivity Disorder–might be at the root of what’s going on. Many people with ADHD, even those receive an appropriate diagnosis and care, struggle with the variety of symptoms that can affect identity development, self-esteem, emotional regulation, daily life routines, and so much more. Yet when you learn how to understand and manage ADHD symptoms, you can make them work for you–and even become a superpower. So today, we’re joined by two top, strength-based specialists–Micah Saviet and Elizabeth Ahmann–who can help you flourish with ADHD.

Topics discussed include emotional regulation, trauma, neurodiversity, shame reduction, identity development, motivation, procrastination, goal management, menopause, perimenopause, retirement, executive functioning, intelligence, reactivity, impulsivity, neuropsychological, neurobiological, ADHD, Attention-Deficit/Hyperactivity Disorder, dopamine, interest-based reward system, hyperalert, hyperactive, parenting, children, neurodiverse, neurotypical, and self-compassion.

Please note that this episode contains sensitive material; listener discretion is advised.

Emergency Assistance Details: If you or someone you know needs immediate support, please call your emergency services. In the US, 24/7 help is available by calling “911,” “988” (Suicide and Crisis Hotline), or SAMSA (Substance Abuse and Mental Health Services Administration) at 1-800-662-HELP (4357). As applicable, additional resources may be provided in the show notes.

Non-Emergency Online Mental Health Information: https://www.nami.org/support-education/nami-helpline/

and https://odphp.health.gov/myhealthfinder/healthy-living/mental-health-and-relationships

IMPORTANT DISCLAIMER: No expert is offering medical or psychological direction or advice; the content is purely informational in nature. Please consult your physician or healthcare provider before undertaking any new regimen or procedure.

Connect with Dr. Carla Manly:

Website: https://www.drcarlamanly.com

Instagram: https://www.instagram.com/drcarlamanly/

Twitter/X: https://www.twitter.com/drcarlamanly/

Facebook: https://www.facebook.com/drcarlamanly

LinkedIn: https://www.linkedin.com/in/carla-marie-manly-8682362b/

YouTube: https://www.youtube.com/@dr_carlamanly_imperfect_love

TikTok: https://www.tiktok.com/@dr_carla_manly

Books by Dr. Carla Manly:

Joy From Fear: Create the Life of Your Dreams by Making Fear Your Friend 

Date Smart: Transform Your Relationships and Love Fearlessly

Aging Joyfully: A Woman’s Guide to Optimal Health, Relationships, and Fulfillment for Her 50s and Beyond

The Joy of Imperfect Love: The Art of Creating Healthy, Securely Attached Relationships

Imperfect Love Relationship & Oracle Card Deck by Dr. Carla Manly:

Etsy

Amazon

Connect with Elizabeth Ahmann:

X/Twitter: https://x.com/lizahmann

LinkedIn: https://www.linkedin.com/in/lizahmann/

Connect with Micah Saviet:

LinkedIn: https://www.linkedin.com/in/micah-saviet/

Other Resources:

Website: https://www.adulttraumaandadhdsolutions.com/

Adult Trauma & ADHD Solutions: https://www.adulttraumaandadhdsolutions.com/

Flourishing with Adult ADHD Book: https://amzn.to/4jwOmtG

Springer Institute: https://bsky.app/profile/springerinstitute.bsky.socia

—

Listen to the podcast here

Got ADHD? Turn It Into Your Superpower!

Do you or a loved one tend to get distracted easily? Do you notice chronic behaviors such as difficulty with attention to detail, forgetfulness, restlessness, or impulsivity? If so, ADHD, attention deficit hyperactivity disorder, might be at the root of what’s going on. Many people with ADHD, even those who receive an appropriate diagnosis and care, find that they suffer from a variety of symptoms that can affect identity development, self-esteem, emotional regulation, daily life routines, and so much more. We’re joined by two top specialists who take a very strength-based approach to providing neurodiversity-affirming care for adults with ADHD.

We’ll focus on this audience’s real-life question. “I love my husband, but his ADHD behavior drives me crazy. He can focus on a project really well if it interests him. The moment I ask him to do something that doesn’t interest him, he’s off to something else within minutes. I’ve learned to cope with most of his ADHD behaviors, but this one drives me crazy. Now I’m noticing that this impulsivity and distractibility is also occurring with our two 11-year-old twin daughters. Do you have any tips for me?” With that issue as the focus of this episode. Please note that, as this episode may contain sensitive information, listener discretion is advised.

I am thrilled to introduce two experts in the field of ADHD, Micah Saviet and Elizabeth Ahmann. Micah is a licensed clinical social worker who specializes in ADHD and trauma. Elizabeth, also known as Liz, is a wellness coach, professor, and researcher, and both are authors of the wonderful book, Flourishing with Adult ADHD. Welcome to the show, Micah and Liz. It’s such a delight to have you with us.

Thank you so much for having us. We really appreciate it.

It’s such a joy to have you both. Also, I’m excited to talk about the book that you’ve done, which is a really well-researched, wonderful book that is much needed in this world. Thank you for that. Before we launch into adult ADHD and how to manage it and work with it, could you tell our audiences first, Micah and then Liz, just a little bit about what makes you you?

That’s a great question. Part of what makes me me is that I am an adult with ADHD. It gives me an intimate understanding of how our neurobiology is different, how our system wiring is different, because I understand it from really a lived experience. That’s a big part of my identity and a big part of what I bring to my professional expertise. I have a hyperfixation with research and getting evidence-based practice out there. That’s one of my biggest hyperfixations, and I’m also a big cook. I do a lot of cooking and gardening as well.

When cooking, what is one of your favorite things to cook?

I’m big into air frying nowadays. I love air frying. Salmon teriyaki is my big one.

Thank you for sharing a sneak peek into your life. I appreciate that, Micah. Also, thanks for sharing that you yourself have ADHD because I think the more that we talk about it and let people know that you can be really successful and high functioning with ADHD. We do not need to be ashamed of it. We do not need to hide it. We can just learn to channel all that energy into working with it. Thank you. Now, Liz, can you tell our audiences just a little bit about what makes you you?

I will start with my link to ADHD also. I am not a person diagnosed with ADHD, but I am married to a person with ADHD, and I have children with ADHD who I had the privilege of homeschooling. I worked with their wonderful traits very closely, and they’re now very successful adults with a lot of self-determination. That’s how I found my way into this ADHD topic. Prior to that, I have a background in nursing and worked for a long time in pediatric nursing.

I have a doctorate in public health. I’m very interested in research. Actually, Micah and I have done a number of studies on both health and wellness coaching and ADHD coaching. That’s just a fun part of my life. I enjoy research as well. That’s part of why we brought so much research and evidence-based information into the book we were writing.

Thank you. Between the two of you, so much expertise. My goodness. I am just thrilled to have two people, and I know, Micah, that you also work from a somatic approach, which I really appreciate. We’re going to have a lot to offer from your varied backgrounds, but that can take us not only into the somatic and the neurobiological piece, but also let people see how they can translate all of your knowledge into everyday practical tips to make ADHD more manageable.

It sounds like the person who wrote in, and that’s not an uncommon question where they really want to work, and they love the person in their lives or maybe themselves with ADHD, but they do not know how to manage the symptoms. When you see them in kids, they might not know how to manage it. This will be a great interview to offer some nice foundational information. Thank you. Who would like to start off by describing ADHD? I know there’s not just one type of ADHD, so maybe describe the different types of ADHD and what those look like in adults. Who wants to start with that?

I was going to offer Micah. I can start from the clinical side of things, because there are many ways to look at ADHD. We can look at the medical model, we can look at the social model, we can look at the disability model, and the moral model. More from this Western medicalized model, we can think of ADHD from the Diagnostic and Statistical Manual, which we use to diagnose mental health conditions and whatnot. ADHD is a little different because it’s not like a mood disorder.

With ADHD and autism, it still is in the DSM, but we’re really looking at criteria around attention. We’re looking at criteria around impulsivity. We’re looking at criteria around focus. These are some of the criteria in the DSM. It’s really important to keep in mind that the criteria in the DSM are really normed on children. These are not normed and created around what commonly shows up for adults with ADHD. Particularly, as you mentioned in your introduction, with adults with ADHD, as well as children, emotional regulation is not in this medical model.

Redefining ADHD as Abundant Attention

The impact on identity and the impact on parts of how we view ourselves. The medical model really looks at this way of like, how can we correct a deficit? How can we treat or fix something like a pathology that’s long with the way we’re functioning? Really, ADHD is not a lack of attention. ADHD is not a disorder of attention. ADHD is an abundance of attention. With ADHD, we have more attention than we know what to do with. With our attention, it is broad-spectrum rather than being able to easily focus it in as we might otherwise be able to do with a neurotypical person.

I’ve never heard anybody describe that before, describe ADHD in that way and I absolutely love it and it resonates with me, I probably have a little bit of ADHD in me, or maybe a lot, but it is that thing where, I’ve noticed it with clients and people in my life where it is, there’s so much going on and so much to absorb. How do I take all of it in and manage all of this that’s coming in? That is something that’s often misunderstood with ADHD.

You described it beautifully and brought it to the front that it is not a deficit. It is an abundance. Tell me if this resonates with you. It’s like turning on a fire hose, where instead of it being like drip out of a kitchen sink, or even a steady flow out of the kitchen sink. It’s like the attention is like this fire hose of information coming at you. Does that resonate?

You make a great point. That’s a nice metaphor there. One thing that I encourage clients to do, whether they’re in therapy or coaching clients who have ADHD, is really start to figure out what metaphor or analogy makes sense for how you picture your ADHD, because that looks so different for different people. ADHD is very heterogeneous. ADHD, you’re seeing with autism and other forms of neurodiversity, it looks very different for one person than it does for somebody else. That’s a beautiful metaphor. I encourage your audiences to think about, if I have ADHD, if I did have ADHD, what metaphor would describe this for me?

The beauty of that is developing personal awareness and the ability to both understand and then explain one’s own life experience rather than just adopting a diagnostic terminology. That’s just really the beginning of developing a positive identity around your own ADHD.

Thank you both. Again, going back to the piece about the metaphor, I’m a big metaphor person, and I know when I’m working with clients, sometimes I’ll offer a metaphor and then they’ll really get it. My metaphor works for them. Other times they want to massage it and personalize the metaphor. That is so helpful because when we find the metaphor that fits for our brain or our heart, whatever way we want to look at it or a combination of both, it can help us get away from that tendency to pathologize issues because pathologizing them, making them something that’s wrong with us rather than saying, “It’s part of what makes me me.”

The more I understand it and do not pathologize it, the less I’ll be shame-based, the more I’ll feel empowered, the more, as Liz, you were saying, the more self-awareness and understanding. That’s the really critical part. We want to just understand ourselves better so then we can channel our energy in that direction. Thank you. Liz, I’ll take this to you, please. When you’re working with adults, what do you think are some of the most pathologized behaviors, and how would you shift those?

People come to me as an ADHD coach with a lot of different things, but so many of those things are pathologized because they are where they’re bumping into things that work better for neurotypical people, like schedules and running late, or as in your example, having a list of things to do and not necessarily following the list in that order or the same priority as a neurotypical person might. A lot of what clients are struggling with is how do they either fit into a neurotypical world, or what do they need to do to make things work better for who they are?

Really, a lot of where we begin is psychoeducation, really understanding for each individual how ADHD is showing up for them. How is executive functioning, which is really a big part of ADHD, showing up for them? Where are they bumping into issues, and what is working well? That exploration around understanding ADHD, executive functioning, and themselves better is always the foundational place to begin, no matter what your goal is. You have to really understand where you’re starting from. I do not know, do you have anything you’d add to that?

I would just add, Carla, that I agree with Liz. You have to understand what’s happening in your brain and your nervous system. Many of our clients with ADHD come in comparing themselves to a neurotypical person and expecting that they perform in that way, but that just does not work. It’s never worked in my experience. You have to understand what is different biologically and neurologically as a starting point.

That’s the way you then are not feeling that you’re wrong all the time, right? It’s the beginning of dismantling some of that stigma and personal stigma around it.

Thank you. That’s where we’ll go next to respond to this audience’s question where they’re also seeing these behaviors in the kiddos or possibly seeing the behaviors in the kiddos. Micah, when you say, “Let’s look at the biological roots, let’s look at what’s going on,” could you talk a little bit about how the person who has ADHD is how they are wired differently? Let’s start with just a gentle understanding of what would make that brain function differently than somebody who can just sit down, check items off the list, get to it, stay tuned, complete the homework assignment, complete all the chores on the list. What’s the difference?

Understanding the Interest-Based Brain

I’ll try to give a high-level overview. Sometimes I nerd out a little bit too much on the differences here. Basically, the first thing that I’m going to explain is that with ADHD, we have what’s called an interest-based nervous system. We respond differently, and we motivate differently because we have an interest-based nervous system. We can motivate and activate ourselves for long periods of time. We do something called hyperfocus, often very effectively, on things that are of interest to us. Now that brings us to, we talk about dopamine.

With ADHD, we have lower levels of active dopamine in our brains. Dopamine is the reward chemical. The reward chemicals that we’re getting, we’re not getting reward chemicals from things that we do not find interesting. A neurotypical person sits down and goes through the chores just because they know this is something I have to do. With ADHD, that’s very difficult for us to do. We think about motivational pathways in our brain in regard to dopamine and being able to activate it to work and motivate structural differences.

If we put someone with ADHD under a brain scan, an fMRI, we see structural differences in their brain when it comes to the motivational pathways. We also see structural differences in their brain when it comes to what’s in the prefrontal cortex or the neocortex with your executive functions. These are things like, I think Liz was mentioning before, organizing, planning, prioritizing, scheduling, strategizing. Emotional regulation is also an executive function. All of these pieces, our executive functions work simultaneously.

Sorting Input in the Prefrontal Cortex

My analogy for executive functions is like pieces of information are coming into a recycling plant. The executive function’s job is to sort paper, plastic, glass, bottles, and newspapers. With ADHD, we actually get less blood flow and less connectivity to our executive functions in our brain. We actually have higher activity in our limbic system and our amygdala, which is fight-or-flight detection. We tend to be generally more easily activated and overwhelmed sensory-wise in our nervous system. We tend to have less connectivity to our executive functions. I just want your audience to know that executive functions are not intelligence. We tend to have above-average intelligence as well.

Thank you. May I please go back to the recycling metaphor? I loved that, and thank you also. I really have to say, for someone who might confuse executive functioning, which is being able to do the calendar, check off the list, prioritize things, that is not intelligence. Because you have ADHD and more difficulties with executive function does not mean you are not intelligent, not at all. Thank you for saying that.

Back to the recycling plant, could you tell me, we’re sorting, and the brain with somebody’s executive functioning is working at a high level. They’re taking it in. They’re sorting it into this pile, that pile. What happens to somebody’s brain if they have ADHD? Does that system just get clogged up and they put things into the wrong bin, or did this just not put them into any bin at all? What happens?

I just even want to take one further step before that. Keep in mind that the information coming into the recycling plant is coming from multiple sources. It’s coming from our senses, our sounds, what we see, what we hear, what we smell, what we touch. It’s coming from our interactions with people. It’s coming from things that we’re reading. It’s coming from things in our own brain, like our thoughts have to travel through our executive functions also to sort through those.

When you talk about that fire hose, many people with ADHD may be getting 50 to a hundred thoughts in any one minute, and we have to sort through those. When it’s coming into that recycling plant, high-speed water intensity flows. It would often get a bottleneck of what tends to happen. When something bottlenecks, it tends to jam, or it tends to build up, or it tends to lead to situations of a shutdown.

There’s a common term, ADHD overwhelm. You just get to that point, and that’s it.

Got it, thank you. It’s almost a different metaphor, but almost like the kitchen sink that gets a clog in it.

It really works very similarly. We have a certain capacity for executive function. That’s why many people in the beginning of the day, or if you get, “This is another ADHD tip,” we need a good amount of protein to start our day often, because that can help fuel and give our brain the fuel that it needs. We tend to have more executive function capacity, but by the end of the day, that capacity tends to be much more depleted.

I am learning so much. I thought I knew a lot about ADHD, but you two are presenting it in a way that is just so beautiful and easy to digest. I do not mean to mix metaphors here, but it is very easy to digest and process this. Thank you. When we take it to the audience’s question, it sounds like the husband may have ADHD. I do not know about the twin kiddos.

When we look at these traits, like the impulsivity that is being mentioned and the tendency to go from thing to thing, the distractibility, I also think that’s pretty typical of eleven-year-olds in general. This person knows her kids and how they are with the husband. What would you offer this person who clearly loves the husband, loves the kiddos, but seems to want some tips that can help her? I do not know if she wants to be more flexible or more understanding or maybe some practical to-do tips. What would you recommend?

I would start with purpose and meaning or purpose and passion. I can just give a personal example. I like a neat kitchen. My husband is not naturally neat. The kitchen can seem like, “I’m so grateful to him for doing the cooking lately.” I come into the kitchen, and it’s very chaotic. If I say, “Could you just keep the kitchen neater?” It’s a reasonable request. I can even break it down, like, could you just not leave the dishes in the sink?

He’s like, yes, but it does not happen. When I can say to him, “It would really help me if I came into the kitchen and there were no dishes in the sink because I feel more relaxed, then his care for me is more of a motivator for him than just keeping the sink neat. He has an emotional commitment, emotional saliency, and a passion around taking care of me, which I appreciate. It changes the whole dynamic.

Beautifully put, Liz, thank you. It goes back to the piece. It seems that, and please check me on this, that Micah was talking about the motivation piece. It’s different. Finding the correct motivator for the individual in this case. Thank goodness your husband loves you and cares for you. Making it about it makes it easier for you, or really better for you. He might not be motivated to clean the sink. He cares about you. What a subtle, that’s a neurolinguistic, that is a powerful neurolinguistic shift. I am going to use that one in my own life. Thank you for that.

It’s such an important thing to really understand if you have a person with ADHD in your life. That motivation really does, as Micah was describing, it’s a brain difference, and it works very differently. In fact, in our book, we have a whole chapter that looks at what the things are that can enhance motivation for someone with ADHD, and really understanding that can help the person themselves when they’re facing motivational challenges and also can help the people in their lives understand maybe how to communicate around certain places where they’re running into trouble. I do not know, do you want to talk a little bit about that?

Hacking Motivation with the PINCH Method

I would just expand what Liz is saying and like to give your audience an acronym that’s very helpful to understand what works for motivation when it comes to the ADHD brain. As Liz mentioned, this emotional saliency is huge. The acronym I’d like to share is called the PINCH acronym. I’ll just break out what that stands for. We do share this in our book as well, but it’s not original to us. Just to clarify, this is out there in the ADHD space. Credit to everyone who brought this forward. Just illustrating this interest-based nervous system, we talk about the P is for play and passion. How can you bring some sense of play or fun to whatever you’re doing? It’s not just folding the laundry. It’s tuning into a podcast.

Another part of the P can be people because a lot of people with ADHD will work better even if they’re working solitary in a coffee shop, for example, or as my husband does, when the other person’s needs matter, or when you’re working on a group project. It just ups the energy and motivation. That P, play, passion, and people is really key.

We use something called body doubling in the ADHD space. This is where you do a task, but you’re doing it with other people, or you’re doing your own task, but you’ve signed up for as many body doubling groups online. Your audience can look up. Other people are doing their work, but it’s concurrent work. That really helps that motivational pathway up. I’ll just move on to the I. We think about interest. Liz, for her husband, changed this from keeping the dishes out of the sink to, “I am going to keep the dishes out of the sink because this helps my wife feel better.” That’s that interest. Tying anything that you’re doing and figuring out how you can tie it to something that is energizing or interesting to you has that emotional saliency with that I.

I’ll give an example of that. I had a client who wanted to save money but had a really difficult time doing it. Were able to really put why they wanted to save money into very concrete terms so that I could take a family trip that notched up the motivation. It was something they were interested in, cared about, and it really helped them move forward with that goal that they were having trouble with.

That is so helpful because some people might see someone who has ADHD as being selfish. Like, “I need to be.” What we’re really talking about is that the brain is motivated differently. You really have to, as with any person, it’s really helpful when you find what motivates somebody, but particularly with the ADHD brain. Thank you. What is the N?

N is this novelty. Novelty is so important. This is doing anything to change, shake things up, do something differently. For people, this can look like something called, when my colleague called it a drink goblin or something, which is having 3 or 4 different types of drinks. One is a coffee drink. One is a soda, sparkly drink. One is a tart lemon drink. For the ADHD brain, this really creates a lot of novelty and dopamine to be able to go back and forth between these differences. It keeps alertness while doing a mundane task like the dishes or laundry or whatever your spouse gives you to do.

Another simple novelty tip some people use is hating to-do lists, but using colored markers or colored pens and shiny stars and so forth so that when they look at the to-do list, they do not mind looking at it. Any way you can find novelty can really help a lot.

Thank you, and we might think of those tips as just for kiddos, but they’re not tips where we’re trying to infantilize anybody. Instead, we’re saying, this works for some people. People like neutral things. People like certain things really toned down for other people. It’s that magical energizing thing that their brains need. It’s just a difference. It’s not good, not bad. If you’re putting sparkly stars on or colored markers, “Go for it. If it works, go for it. “Thank you. Now we have the N. What about the C?

This is where we think of competition and challenge, right? This is where we think of things like what’s called gamification. Gamification is a whole field of this research and a lot of really cool apps out there that support this idea of gamification.

Turning things into a game, basically. It can be non-electronic or, as Micah’s talking about, often electronic as well.

Seeing how you can beat your prior score, or like there are tools online called Goblin Tools. It’s just a website, Goblin.tools. They can help you break down things into gamification. There are certain apps like Habitica and other apps out there, which are basically turning everyday mundane tasks or life things that you have to do into something where you can level up if you get it done. You can get a score if you get it done.

Audiences can also make that themselves. They can create a sheet, a chore chart, and a certain amount of chores that you do. You get certain points, and then the points. The points you can redeem towards Starbucks or something else or something fun. Again, I just want to emphasize, as you said, these can sound childish at first, but these are the ways to hack motivation for an ADHD brain.

Thank you for calling that out. For some people, it may feel childish, but adults, like people at every age, we need strategies that keep us on whatever road we want to be on. It does not make it childish to want to gamify something. It’s really great that you’re bringing this up so somebody does not feel ashamed or like, “Why do I need to gamify things?” It’s because it’s fun. Everybody, you know, some people want to gamify things. I know my husband loves to gamify things. If you ask him to help fold the laundry, not interested. If you time folding the laundry, “He’s all about it because now it’s a game.”

How much can you fold in ten minutes?

He’s all in. It can just add fun to it. That’s really helpful to realize that it does not mean, again, that you’re infantilizing somebody or making somebody a child. It simply means knowing that the brain is different and we all need dopamine. Dopamine is that neurochemical that helps us get excited about doing something. Correct me if I’m wrong, but I think that research shows that you actually get so much dopamine just by thinking about the task ahead. It’s one of the reasons that it can make gambling so addictive. You get so excited about winning the big pot. You’re already flooded with dopamine. Is that your understanding of how dopamine works? You get this huge burst as you’re headed into what is a possibility of a reward, even before you get the reward?

That’s my understanding also because the brain technically does not know the difference between real and perceived activity. That’s like your brain is already thinking that you’re doing the thing, even though you’re not actually doing it.

Realizing that all we want is some of this really nice dopamine that makes us feel good and excited and then pat ourselves on the back, whether it’s literally or through, as you were saying, an app that gives you some kudos. It feels good.

Fact is, those of us who do not have ADHD naturally have more dopamine. We may just get satisfied getting the laundry folded and put away, because there it is. If you do not have that same amount of dopamine, a more tedious task is harder to do unless you create a way to raise your own dopamine. It’s really just a strategy to work with how your brain functions better.

Thank you. Liz, that makes perfect sense. You’re really making all of this very understandable for audience so that they can, again, not shame themselves or someone in their lives and just see it’s a different neurobiology. It’s just different. Learning to understand the strategies, which takes us to the last one. What is the H?

You were actually getting at the H when you were discussing that, the timing, how many towels can you fold in ten minutes? This is the hurry-up or urgency. This is really using things like planned procrastination, knowing that our ADHD brains tend to work best under pressure. I have clients for weeks. They have a project due in three months. For two and a half months, they cannot get themselves to do any part of this project. In the two weeks or the week or even the five days before the project is due, they can do the entire thing better than they would have done doing it over several months.

A totally normal way we think of this is like students pulling an all-nighter. The ADHD brain can often work better under that time pressure. You do not want to use it all the time because it can also be exhausting and stressful. If you are using it purposely for certain things, like Micah said, planning procrastination, it can take pressure off. For three months, you’re not saying, “I haven’t started. I’m never going to do this. I’m not good at it.” You’re saying to yourself, “This project will take me two weeks to do, and I am going to start three weeks before it’s due. I am not going to worry that I’m not doing it until then.” That’s just working with your brain. Plain procrastination and other ways you can bring urgency into situations.

Thank you both because I think that’s so critical to actually plan. I know I tend to work better under pressure as well. I know that about myself. I’m like, “I am not going to shame myself or blame myself that I’m not doing this instead. I know that I really like a crunch when it comes to certain, not every project, but certain projects. Some I need an abundance of time. I wait till the end. I am going to start on it here, but I will be prepared to go all day to do it.” When we make it our normal and work with it and understand it instead of all again, not pathologizing. I really appreciate that.

I also, and this goes to Liz, thank you for that. Micah, I appreciate the part where you were talking about how important it is when we have a task and that sense of urgency comes up, which it can often, and I see this in certain people, where they keep the urgency going, which is causing increased adrenaline, increased stress, elevated levels of cortisol and adrenaline in the system, and doing that on a chronic level is not good for us. This goes back to the piece where we can work with it on the somatic level. How can we turn down that urgency when it’s not helping us, and it’s more just a reactive response that is causing us stress? Either Micah or Liz, one, please. I’d love to start with that, and I’ll just add to that.

I’d love to start with that. In neurodivergent nervous systems, with ADHD and autism, we tend to have nervous systems that are more reactive to smaller things than a neurotypical nervous system. We tend to have hyperreactive nervous systems. Also, the research says we tend to stay in a hyperaroused, activated, anxious state longer than a neurotypical nervous system. Both of those points are really important. We tend to get activated more easily and quicker, and it tends to take us longer to come down from that activated state. Really, you’re pointing to a really important piece, which is the somatic piece. I guess I’ll just pause there to see how that sits.

You said it so beautifully that you get activated, if I heard you right, more quickly and you stay activated longer, which means if you’re in that, say, fight-or-flight mode, just to keep it simple, the terminology people understand, you’re poised and ready to go more quickly, and you’re in that more aroused state longer. For someone who can take a deep breath in, deep breath out, go on for their day, go on with their day pretty easily, not so easy for the person who has ADHD. Did I get that right?

Exactly.

What is, or what are some techniques that this mom, when we look at the mom and the wife, or that we can all use if we are ADHD, to help us notice that, “I’m activated. I am going to tend to be in this state longer, or my loved one is in this state.” What are some tips?

I guess there are two answers to this. One is the sequence of steps, and then one is how you do it. The first thing is we cannot use our executive functions when we’re in that state. Meaning the first step is to be aware of what state you’re currently in if you’re in a fight-or-flight state. The second step is to regulate. The third step is to engage in that executive function work that needs to happen. Great practice. Liz is mentioning this practice of STOP is a great place to start for that first step, which is to be aware.

Shifting from Reaction to Response with STOP

If you think of a stop sign, you have the letters STOP. This is sometimes considered a little mini mindfulness exercise, but it can be. It can be any time during your day if you feel really revved up or if you feel stuck. S, stop and take a breath. Just stop. Take a breath. T, that’s the take a breath. O, observe what’s going on. Observe how you feel, observe what’s going on around you, observe what’s going on with your senses, and if you feel overloaded. Just really take a moment to observe, and then P is proceeds. I really like to say to my clients, proceed with a plan, make a choice at that point rather than just reacting. I do not know if you have anything.

Just say that that’s the key difference, because for ADHD, so often we’re on autopilot. We’re just reacting, reacting to this, reacting to that. As you mentioned earlier, impulsively doing this, impulsively doing that. To me, reacting is impulsivity. The opposite of reacting is responding, and responding is choice and agency. That’s really what we’re talking about here when we’re talking about pausing, taking a breath, observing may seem very simple, but it actually puts you back into your noticing mind.

It grounds you.

It takes you away from that fight or flight mind. It starts to bring you back into your curious noticing mind, curious observer. That allows you to engage in that choice.

Thank you so much. As you’re talking about this, then it’s an entirely different episode. You’re a different topic where it’s reminding me a lot of trauma work. When there is this hypervigilance and whatever’s causing that switch into that really activated mode. Using what you were talking about here because we’re talking about activation. You’re right, when we’re activated, the brain’s saying, a bear’s chasing you, run. We’re not thinking and planning. We are just going. The bear’s going to attack you. Hide, whatever’s happening. What you’re talking about is really also pertinent.

I know that, Micah, you also work with trauma. This is really helpful for any audience who’s saying, “Wait, I know that activated state. Maybe I see it in myself, maybe I see it in my partner or my kids or a friend who maybe does not have ADHD, but has unresolved trauma that we can use these strategies.” I’ll just reiterate the STOP when you see that, because we cannot respond appropriately to ourselves or to a loved one when we are in an activated state. The prefrontal cortex is just not working. It’s not our fault. It’s just not working.

When we see a big red stop sign and use the S to stop the T to breathe, we’re bringing on our parasympathetic nervous system. We’re calming things down. We do the O, which is the observe. Just try and get a little distance from yourself in the situation, back up a little bit, and the P to pause. As you said, plan. Let me plan what I’m going to do here. I’m not going to lash out. I’m not going to run into another task or run away, whatever, but I’m going to plan. What is the next best move here?

The wisest move. This is so helpful because when we look through the lens of your STOP sign strategy, it’s so helpful. We can use it all the time, ADHD or not. Thank you for that. I do have a question for you a little bit. For this audience, I’m wondering. Micah or Liz, either both, have you noticed that ADHD symptoms tend to, if they’re not treated, or even if they are, if somebody’s using medication, can they get worse as a person ages? Do they tend to remain static throughout the lifetime?

There are several answers. One is that the way you operate in the world is different in different life circumstances. The way you operate at home, the way you operate at work, whether you’re neurotypical or neurodivergent, it’s going to be different. It’s calling out different aspects of yourself and aspects of your skill sets. The woman’s husband, I do not know how he operates at work, and maybe at home his executive functions are tapped, and it’s not a good time for him to take on a task in the evening.

Also, as we go through different stages of life, our ability to manage our environment is different as well. I’m older, and my executive functions may be a little slower than Micah’s, and that’s going to be magnified in someone who has executive functioning challenges. Yes, age can interact with ADHD, and a person who’s really done some interesting work around that is Kathleen Nadeau. I think she has a book on aging and ADHD. For any audiences who are curious about that, her work is really wonderful.

Navigating ADHD Across Hormones and Lifespan

I’ll just share, just to add on there, over time as we age, we also tend to have less support. We think about when we’re younger. We tend to have more support at school and at home. Even in college, there’s a big shift, and we have much more support. As we tend to get older, society expects us to be more independent and have less support, and another big shift, which can exacerbate ADHD symptoms because we have less executive function support outside of us. Another big shift just for your audience to be aware of is that menopause tends to be another big shift for women when ADHD symptoms tend to be much more impairing and tend to come out a lot more, even if they weren’t able to cope and mask before.

Also, just in terms of life progression, retirement is a huge challenge for people with ADHD at times because when you’re in the workplace, you tend to have a structure. You’re structured by time, you’re structured by task, and when you retire, you have to create all your own structure. If you do not have the easiest time with executive functions, that’s more difficult. You do not plan as well. You do not organize as well. Getting some help to figure out how you’re going to move into retirement can really be useful to someone with ADHD.

Thank you both of you. Micah, thank you for bringing up the menopause piece because many women without ADHD struggle with brain fog and other issues as their estrogen starts taking more and more of a nosedive. They already feel bad. Somebody who has ADHD, that’s going to be compounded. When they do not realize, “Wait, this is working. There’s synergy here that can really exacerbate these symptoms.” Thank you for calling that out. Liz, thank you for calling out the retirement piece because I agree with what I’ve seen with clients with ADHD. They really do like their structure.

Whether the structure is imposed by themselves or by a work routine, the structure can feel really supportive. Noticing and just preparing for it. It doesn’t mean that there’s something wrong with you. It just means you need a little support, and we all need support. It’s just what type of support do we need? Really taking that individualized approach, again, not pathologizing. I love that you two both come from such a strength-based approach. Final question that might be simmering in the back of some people’s minds. Is there a big shift when you have ADHD, but you’re not really seeing the hyperactivity in a person? Would you say anything differently for someone who’s more attention-deficit without the hyperactive part?

I would mention that in adulthood, you’re less likely to see what you typically think of as hyperactivity, but there may be restlessness, difficulty sitting still.

Even internal restlessness, even like not being able to sit with comfort on stools.

I’ll sometimes sit at a restaurant, and I’ll see someone under the table whose leg is shaking the entire time they’re talking, and I’m thinking to myself. “There’s a little restlessness there.” They’re maintaining their focus on the conversation, but to do that, they’re having to move their leg constantly in order to compensate and be able to focus. That’s one thing about hyperactivity, but not everybody has a hyperactive presentation of ADHD. There are three “presentations” in the DSM. Some people are predominantly inattentive. Some people are predominantly hyperactive, and then some people have a mixed thing.

If you think historically, more women tend to be more of the inattentive type compared to males. If you think back, who used to get pointed to as having ADHD in school, it was boys more often because they were having trouble sitting still, moving around, like standing up, raising their hand, talking out, because they were more hyperactive. The girls maybe were sitting there, dreaming about whatever and still not getting their work done effectively, but they weren’t creating a bother in the classroom. They weren’t sent out for a diagnosis. It’s that more inattentive thing, which can create as many challenges for an individual as hyperactivity.

It can also be more impairing, too, because you tend to learn how to do what’s called masking, which is to show up a certain way in certain situations. You tend not to get the help that you needed early on. I guess I’m just emphasizing that. The inattentive presentation, which most adults grow out of hyperactivity, tends to, and most women and girls tend not to always have that hyperactive component. It doesn’t mean that your symptoms are less severe or less impairing. In fact, it can be more so, and you may have gone for more years struggling without the support that you need.

I’ll add to that too. What often happens to women is that their symptoms are considered anxiety and depression before an ADHD diagnosis is even considered because they’re more internal, because it’s inattention and they’re not acting out. It’s often misdiagnosed at least initially. Many women with ADHD get diagnosed later in life. It’s both huge. “Thank God it wasn’t something wrong with me. It’s just my neurobiology.” It also can really throw you into some grief for your past and also put you in a position where you’re having to renegotiate your identity as a person. There are a lot of pieces there as well.

I like how you brought it back to the diagnosis, that we do not want to use a diagnosis of ADHD or anything else to shame or limit or pathologize anyone, but to give people the information they need so that they can take whatever issues they’re juggling and work with them in a way that makes them feel better and stronger and more in tune with themselves. That, to me, is the entire goal of it and removing the shame.

If somebody in your life is shaming you or you’re shaming yourself, I think that’s when it’s especially vital to seek a coach or a professional who can help you make friends with whatever’s going on inside your nervous system, inside your entire neurobiological picture so that you can really come to love and understand yourself and work with yourself.

That’s really one reason we wrote our book, Flourishing with Adult ADHD, is to help move the conversation from diagnosis to wellbeing, to knowing yourself, figuring out how you operate, and having wellbeing and moving towards flourishing. That’s really the whole strengths-based neuroaffirming approach we take in our book, which we wrote with therapists, other clinicians, and coaches in mind, but which actually some adults with ADHD themselves are finding really helpful for the perspective that it brings them.

Thank you both. Are there any other pieces that you would like to share before we begin wrapping up? Any final tips, thoughts?

I would say the other thing we didn’t talk about at all that is so important is self-compassion. Through self-compassion and through learning to understand yourself, you begin to find that place that you can more confidently operate from. I would just say, I’m not sure we explicitly mentioned it, but finding other people with ADHD is essential here.

Building Healing Community and Self-Compassion

It’s very hard to give yourself compassion and understanding if you’re just thinking about this inside of a bubble. For so many people, this is why group coaching, group therapy, even just support groups or peer-run groups of adults with ADHD. There are many out there. You can get on the Children and Adults with ADHD website and look for support groups that way. It’s just such an instrumental part. You cannot understand yourself and heal without community when it comes to ADHD.

I’ve had clients who’ve found those support groups and use them and will say, “I found my people,” like they really found they belong somewhere in such an affirming way. That’s really important. I agree with Micah.

Thank you. That’s such a really important piece. Often, with not any mental health diagnosis, but with many diagnoses, whether it’s a mental health issue or a physical health issue, it’s so important to have community. Sometimes people cannot afford therapy. Being able to access a group. Groups, generally they’re often free. It can give you a sense of, “Wait, I’m not alone.”

It’s not just me.

500 other people have this. “That’s happening in your life.” It can feel so validating. People of all walks of life have ADHD. People who are extremely successful in so many ways. People who haven’t made the most of their ability to be successful because they’ve been marginalized or ashamed or whatever. Thank you. I’ll be sure to put a link. I’m not aware of what you were talking about. I’ll be sure to include that. Wonderful guests, Micah and Liz. Where can our audiences find you?

Thank you so much. Liz and I, our research institute, if you’re interested in the research side of things, can be located at SpringerInstitute.org. We both do ADHD and wellbeing coaching at PathwaysAhead.com. I can send you these to include in the show notes. I do somatic trauma therapy and, for neurodivergent folks, also work with the chronic illness community. I’m in Maryland, DC, and Virginia is where my licensures currently are, but that’s at Adult Trauma & ADHD Solutions. We’re also on social media. You can follow me on Instagram and whatnot.

You can find our book published by Routledge, and it’s also available on Amazon and is now also available as an audiobook.

Wonderful. Audiobooks can be especially helpful for people with ADHD because they can listen to them while they’re walking or doing some other tasks that can help focus. Thank you again. I appreciate it so much. Audiences, please do not worry if you do not have a pen handy. The links that we’ve talked about will be in the show notes. Click on a button. They will be there. You’ll be able to find both Micah and Liz. Thank you again, Micah and Liz. It has been such a joy and such a privilege. I’m truly grateful. Thank you.

Thank you for having us.

Thank you so much. Thank you.

To our audiences, as always, it is such a joy, a privilege, and a pleasure to share time and information with you. This is Imperfect Love.

Important Links

• Adult Trauma & ADHD Solutions
• Adult Trauma & ADHD Solutions on Facebook
• Adult Trauma & ADHD Solutions on Instagram
• Pathways Ahead on Facebook
• Elizabeth Ahmann on X
• Elizabeth Ahmann on LinkedIn
• Micah Saviet on LinkedIn
• Springer Institute
• Flourishing with Adult ADHD – Routledge
• Flourishing with Adult ADHD – Amazon
• Flourishing with Adult ADHD – Barnes and Noble
• CHADD Affiliate Locator
• Rooted, Regulated, and Resilient: Living with Presence & Purpose for Neurodivergent Adults
• ADDA
• Dr. Carla Manly’s Website
• Dr. Carla Manly on Instagram
• Dr. Carla Manly on X
• Dr. Carla Manly on Facebook
• Dr. Carla Manly on LinkedIn
• Dr. Carla Manly on YouTube
• Dr. Carla Manly on TikTok
• NAMI HelpLine
• Mental Health and Relationships

About Elizabeth Ahmann, ScD, RN, PCC, NBC-HWC

Elizabeth Ahmann, ScD, RN, PCC, NBC-HWC is an ADHD and health and wellness coach, professor, researcher, and Curriculum Manager in the Health and Wellness Coaching Department at Notre Dame of Maryland University’s School of Integrative Health. She also serves as Director of Research at Springer Institute. Elizabeth Ahmann is the first author of Flourishing with Adult ADHD, bringing expertise in public health, nursing, coaching, and translating research into clinical and practical guidance.

About Micah Saviet, LCSW-C, NBC-HWC

Micah Saviet, LCSW-C, NBC-HWC, is a licensed clinical social worker specializing in trauma-informed, neurodiversity-affirming care for adults with ADHD. Micah integrates evidence-based, somatic, and neurophysiological approaches to support clients in healing from shame, emotional dysregulation, and trauma-related patterns commonly experienced by neurodivergent adults.

Micah’s work emphasizes moving beyond symptom management toward deeper healing, self-compassion, and sustainable well-being. He writes and speaks on adult ADHD, trauma, nervous system regulation, and strengths-based care for professionals.