If you're new to the ADHD world, or even a seasoned veteran, you may have seen this ADHD Iceberg meme floating around.
At first glance, it's a wonderful visual that shows there's so much more to ADHD than what the general public tends to acknowledge.
However, I've noticed that it raises a lot of questions with my clients and their families. How are hyperfixations possible when focus is a struggle? Why do I forget to use the bathroom or eat throughout the day?
So, here's what I've gathered from social media and clients about their experiences with these characteristics and how we can explain them to non-ADHDers.
Each aspect will have a definition, real-world examples, questions to ask to promote self-awareness and troubleshooting, and at least 3 strategies to cope with these aspects.
1. Poor sense of time – commonly called time blindness and medically recognized as time aphasia
ADHDers struggle with what most might think of as "nearsightedness" when it comes to time. There's a struggle with understanding the concept of time and how long things actually take to complete. Now, I'm no medical expert, but what I can say anecdotally is that I know how long a song takes so I know my showers are generally 10 minutes or less… but without music, I'd be in there all day.
Here are some things that other ADHDers have said in regards to their time aphasia:
I allow for 25% more time than I think I need for something to make sure that I have enough time allotted.
I've set all of my clocks 5-10 minutes fast, and each of them is different so I am getting things done late, but early.
Time doesn't pass linearly – I have to have timers to keep track of what I'm doing.
I'm chronically early to things to avoid being chronically late.
An unnerving feeling that I don't live in the same reality as other people; that so many of my emotions and decisions should be governed by how long it's been since X or Y.
It's not that I don't understand time but it has a habit of not operating in a predictable or regular fashion, either in the short or the long term. It catches me unawares.
If something happened more than a week ago, it's hard for me to tell how long it's been without tying it to some sort of major event that I remember the date of. So sometimes I'll think something was just two months ago but it was over a year ago or vice versa.
You know how fun things feel like they pass quickly and boring things pass slowly? That feeling, except all the time, and it switches back and forth, and has no consistency between fun and boring, and also maxes it out to 1000x. And I can't estimate the time.
Things we recommend for working with time aphasia:
Questions to ask yourself: When does time feel easiest to manage? Make a note of all of the things that make the time easy in those moments and try to use those same tools throughout your day.
Strategy No. 1: Use songs to keep track of time. Shower playlists that are limited to 3-5 songs, homework playlists that are broken up by song type to signal breaks/work time, cleaning playlists that are 30 minutes long to signal resting points, etc.
Strategy No. 2: Set timers without expectations and see what you can get done in 10/15 minutes so that you have an idea of what can be accomplished in a set amount of time.
Strategy No. 3: Keep a log of what you were able to get done in a set amount of time. This can be a checklist, journal, or calendar to see what projects/tasks take a certain amount of time. I like to try to beat the microwave whenever I'm completing a task… It's silly, but it helped me realize that it only takes 2 minutes to unload a dishwasher.
2. Hyperfixations - commonly referred to as hyperfocus
ADHDers can struggle and thrive with Hyperfixations. These can be moments of high-intensity productivity or emotional drive that come with a sense of urgency or need. These can be periods of focus on things that may not seem relevant to a neurotypical (someone without ADHD), or it could be a period of focus on a big project the night before it's due.
Here are some things that other ADHDers have said in regards to their Hyperfixations:
Helpful
I can get a month's worth of work done in a week as long as the dopamine is there
Almost a drunken feeling of inhibited desire to complete a task
Creative Gift
Strong infatuation where everything else disappears (good and bad)
Good Romance
Hurtful
When I'm hyper-focusing I neglect basic needs
Losing sense of time in the moment and unable to realize it until it's probably too late
Scheduling nightmare
Strong infatuation where everything else disappears and this becomes the obsession
Love Curse
Things we recommend for working with hyperfixations:
Questions to Ask Yourself: What are the signals of hyperfocus for me? When is it helpful and when is it harmful? What supports will help me lean into the helpful parts and combat the harmful parts? Where is the pause button or end point of this hyperfocus?
Strategy No. 1: Practice Mindfulness and mindful awareness.
Strategy No. 2: Have a podcast or tv show on in the background about your hyper fixation while you complete daily tasks to avoid getting lost in the ADHD wormholes.
Strategy No. 3: Work with a professional or trusted friend on accountability and supports when hyperfixations take over. Using the strategies and questions above should help with awareness of these moments and will help you understand when to reach out for support. It's okay to ask for help.
3. Sensory/auditory processing disorder (SPD)
SPD can show up in a lot of different ways and each person's experience is different. If you're not familiar with it, neurotypicals might compare it to hearing a song that annoys you, but on repeat. Or having to touch the bottom of the sink drain to clear it out, but constantly. Or smelling your least favorite candle EVERYWHERE. But these are sensations that can be triggered by very small or very large things.
Here are some things that other ADHDers have said in regards to their SPD:
Either FREEZING or HEAT EXHAUSTION – very little middle ground
Textures and flavors can become overwhelming
My brain registered that you are talking, can hear what you're saying, but can't process what it means
Bright lights can have sounds to them and they hurt my eyes
High-pitched beeps or tones or loud noises cause my vision to scramble like a cable TV station that you don't subscribe to.
Some sounds, textures, smells, etc, send my body into a small panic
Things we recommend for working with SPD:
Questions to Ask Yourself: What senses do I notice get triggered most easily? When do I not get triggered? When do I notice that it happens most? What supports make these easier to manage?
Strategy No. 1: Use Sensory tools like these to work WITH your Senses instead of against them.
Strategy No. 2: Learn your triggers and create a safe space - this may require help from a professional but it's worth the work. Once you can recognize your sensory triggers you can create a safe space away from them to ensure you don't have sensory overload.
Strategy No. 3: Take frequent sensory breaks - whether you are understimulated or overstimulated, find time during your day where you can get up and escape or engage your senses depending on what you need. 5-10 minutes is normally enough time to get a reset, but you know yourself best so take the time that feels right for you.
4. Forgetting to eat, sleep, go to the bathroom - Forgetting basic needs
Forgetting to eat, sleep, or go to the bathroom may sound odd to a neurotypical because when you need these things your body tells you. However, people with ADHD and many neurodivergents struggle with interoception - or knowing what's going on in your body.
For example, in my experience, it took me until I was diagnosed (at age 30) to realize that what I had labeled as anxiety, was actually hunger. Feeling a light headed, nauseous, panicky feeling that most people would say are symptoms of an upcoming anxiety episode are actually quite similar to the feeling of hunger when you've forgotten to eat all day.
Here are some things that other ADHDers have said in regards to forgetting their basic needs:
Not understanding what enough food, sleep, and water is
Signals for eating, sleeping, and drinking don't register when they should
SYSTEMS OVER ROUTINES (I've said this before and I'll say it again – systems and structures are NOT routines see the link under Executive Dysfunction for an example)
Things we recommend for working with forgetting basic needs:
Questions to Ask yourself: When was the last time that I ate? When was the last time I went to the bathroom? When was the last time I had water?
Strategy No. 1: Seeking support from a medical professional with an emphasis on Meditation, CBT or DBT therapy can help with mindfulness and awareness of what's happening in your body.
Strategy No. 2: Have an accountability buddy that you check in with at meal times or break times to make sure you're meeting your basic needs. Once you can follow their routine, you'll be able to implement your own.
Strategy No. 3: Log the sensations that you're feeling and try to explain them to those around you. Compare notes to see what your sensations are like compared to others. This is a great practice among trusted friends. For example, after explaining what my anxiety felt like to a friend… I realized it was hunger… because I wasn't eating enough.
5. Executive Dysfunction
Executive dysfunction is one of the most common struggles of people with ADHD. It's almost like our brain didn't come with the same manual as the general public.
It's what neurotypicals may label as "common sense" or "street smarts", understanding what needs to be done, how to get it done, when to complete the steps, where to complete the thing, and being motivated by the why. ADHD brains are missing most of the cues that make these functions possible.
Here are some things that other ADHDers have said about their executive dysfunction:
Brain is SCREAMING to do the thing but not giving you the tools to START the thing
A wall that's blocking you from doing the thing – Wall of Awful
The thinking and planning portions of my brain disconnect from the execution part of my brain. The "me" that wants to get things done is trapped.
Frozen with your mind active
It's like trying to get yourself to jump off of a ledge without the fall.
We have the desire and want, but no ability to move forward.
It's like when your iphone is in low power mode and all energy moves to the most essential things
Things we recommend for working with executive dysfunction:
Questions to Ask Yourself: When do I find it easy to manage different aspects of my life? How can I connect those areas to where I'm struggling?
Strategy No. 1: Use the SYSTEMS Template for ADHD support. Here's an example.
Strategy No. 2: Find an executive function coach in your area or someone who can work with you virtually. (Like us!)
Strategy No. 3: Take an EF Survey like this one. Find your strengths and brainstorm with a professional or trusted friend on how to use your strengths to work with your areas of weakness.
6. Rejection sensitive dysphoria (RSD)
RSD can be defined as an intense reaction to perceived or real rejection. It can present itself as anxiety around thinking people hate you, or concerns about someone rejecting a suggestion.
It may also be labeled as imposter syndrome/imposter phenomenon and can manifest itself with intense feelings of guilt and shame, which are big signal emotions for ADHD which can ripple into executive dysfunction.
Here are some things that other ADHDers have said in regard to their RSD:
When it's passion focused - creative
Social situations
When being vulnerable with a partner – Shame and Guilt – Big Signal Emotions
RSD makes me cry on a regular basis and assumes I am garbage and everyone hates me.
Trouble with honesty with accountability
Things we recommend for working with RSD:
Questions to Ask Yourself: What was a win for today? What small tasks did you complete that you can celebrate today? What would I say to a friend who was feeling this way?
Strategy No. 1: Remember that ADHD brains fluctuate with dopamine and serotonin levels from day to day. The expectations that were realistic yesterday, might not be achievable today and that's okay. Practice patience with yourself, and most of all - self-kindness.
Strategy No. 2: Find resources that validate the experience. Check out this podcast about RSD - it's only 19 minutes (here's the transcript) and goes into detail about how ADHD brains process RSD. It could also be a great tool for explaining to friends and loved ones about what it feels like.
Strategy No. 3: Something I do is keep up with notes from friends, kind things coworkers have said, and other celebratory items around my house as reminders of what is real vs. what I've made up in my head about any given scenario. RSD is a real monster.
7. Hyperactivity - internal - problems focusing/anxiety/mood regulation & external - uncontrollable fidgeting
ADHDers can exhibit hyperactivity in a few different ways but most commonly present internally OR externally. This can come in the form of people who are super active in sports and struggle with sitting still for extended periods of time. It can also be commonly present in people who are extraordinarily creative and often daydream. In my experience, the hyperactivity that I go through can start as a hyper fixation, lead to RSD, and then end with anxiety - which impacts interoception and executive functioning. ADHD is fun, right?
Here are some things that other ADHDers have said in regards to their hyperactivity:
Internal
Angry bees
Jukebox that keeps skipping songs
Ever seen a cat with the zoomies? It's like that but in my brain
My brain is Grand Central Station with each train going in a different direction
My brain can't filter through information, it has to process every thought and input all at once - it's really tiring
External
Constant fidgeting
Needing to be active/talking at all hours of the day
Constantly looking for another activity or movement break
Things we recommend for working with hyperactivity:
Questions to Ask yourself What are my realistic expectations for today? What can I get done and how can I make sure to get it done in a way that feels productive to me? Where can I go to make sure that my working and personal needs are met effectively so that I can focus and feel productive?
Strategy No. 1: Develop a routine that allows for outlets for this hyperactivity. I found a movement that I enjoyed (bouldering) that I fit in for 20-30 minutes a day and a creative outlet for my brain whirring (blogging/journaling) that I try to do at least once a week.
Strategy No. 2: Take breaks throughout the day to allow for brain dumps or movement. This can look like a call to a friend, a journaling break, a walk around the block, or even just doing some jumping jacks or having a karaoke car drive!
Strategy No. 3: Be kind to yourself and respect your limits. The last thing you want to do is work against the angry bees or the need to move. Remember that your brain fluctuates every day, and you have to work with it.
If you're looking for individualized support navigating any of these 7 things, or anything else related to ADHD, reach out for a free consultation! I work with people who have ADHD as well as parents who want support on helping their ADHD child.