From a talk by Ari Tuckman, PhD, a truly good explainer. 

There are six fundamental strategies that underlie all the ‘how-to manage’ lists:

1. Reduce extraneous stimuli – limit your exposure to distractions
2. Amplify relevant stimuli – keep the important stuff in front of you
3. Seek out situations that allow safe expression of hyperactivity
4. Minimize situations that require more restraint than you can muster
5. Create barriers to problematic actions by reducing tempting stimuli
6. Set up cushions to reduce the damage done from impulsive acts

​More here...

If you haven't yet heard that meditation is good for you, then let's fix that right now!  Meditation, in all its various forms and styles, has been repeatedly shown to be good for your brain, your body, your stress response and your overall well-being. 

And, like many things that are good for us, meditation isn't always easy to do. After all, the mind was made to wander!

One option - listening to audio of guided imagery practices. Guided imagery has been described as "the easiest, most user-friendly form of meditation you can find. It’s simply listening to words and music that guide you on a positive journey, where you imagine yourself relaxing and doing well, with all your senses. Even half-listening works."

Where to start?

HealthJourneys.com offers audio guided imagery and self-hypnosis practices aimed at strengthening mind and body for all manner of health and wellness concerns. HJs also partners with hospitals, health insurance companies, universities/colleges and other organizations to make selected practices available for free. ADHD-relevant practices to aid Focus/Concentration, Procrastination, Anxiety, Depression, Sleep and other concerns are downloadable here, thanks to the Student Health and Wellness Service of the Los Rios Community College District in California.  

Is guided imagery the easiest way to meditate? Try and see.

When looking for a new therapist online, whenever possible, look in the places most likely to attract therapists interested in your issue, i.e., the professional associations for your concern that offer professional directories.

Examples:

• for ADHD, check out CHADD, Children & Adults with ADD at chadd.org and ADDA, the Attention Deficit Disorder Association at  add.org 
• for anxiety, ADAA, the Anxiety and Depression Association of America at adaa.org 
• for OCD, IOCDF, the International OCD Foundation at iacdaf.org

​Should you want to stay local, look for professional associations in your county or area with directories. Around here, that includes:

• the Ventura County Psychological Association at venturacountypsych.com
• the Mental Health Professionals of the Conejo Valley at mentalhealthconejo.org
• the LA County Psychological Association at lacpa.org
• the Santa Barbara County Psychological Association at sbcpa.org 

If you want to find someone who takes your insurance, insurance company websites usually list their contracted providers. Be sure to check the details regarding copays and deductible. 

There are many general directories that come in various flavors. A few examples:

• Psychology Today Therapist directory - the biggest
• GoodTherapy.org - another broadly based directory
• Therapy Den - inclusive, intersectional
• Open Path Psychotherapy Collective - therapists offering services at low-cost and sliding scale

Tip: if a therapist has a website, always check it out before contacting them. Many of the questions prospective clients ask about fees, insurance and areas of expertise can be addressed in  more detail there than in a directory listing. Doing a little research will save you (and us) time and energy.

For more tips finding your new therapist, see Part 1

...and it seems like no one is accepting new clients, me included. It could even hard to get someone to call you back.

What to do?

A. Don't take it personally. Many therapists are extra busy these days. 2020-2021 has (a) been incredibly stressful, which, (b) is reducing the stigma around getting therapy, resulting in an increased demand for services.

B. Keep in mind that it's normal for the process to take a while, especially now. Keep trying. 

C. Widen your net - if you're okay with doing therapy via telehealth, you can see any mental health professional licensed in your state. 

D. Pique our interest - think about what you'd like to get out of therapy - not only the problem(s), but also what you're hoping to gain or to become. We therapists tend to be suckers for hope - so mention yours when you contact us. 

E. In your message, be sure to mention that you've looked at our website (after having done so, of course) and are very interested in working with us. 

F. About the (lack of) call backs - unlike doctors, most of us in private practice don't have admin help to run our small businesses. When we're full up, returning inquiry calls can, unfortunately, fall to the bottom of the to-do list. 

Suggestion - frame your inquiry so that no reply means no openings, like this:

See how that works? If you don't hear back, it's safe to assume they don't have any openings. The therapist will appreciate your courtesy and you're less likely to feel you've been ghosted. 

G. Don't be afraid to call again, in a "I know you're busy so I'm checking back" kind of way. 


Next up, Part 2 - online therapist directories. 

GENIUS! Practical, doable advice on how you can take the edge off of those endless spiralling COVID-19 worries, from Yale psychologist Dr. Laurie Santos, UMich psychologist Ethan Kross and...Lebron James (whaat?) Plus, a (slightly) evil psychology experiment. Listen at happinesslab.fm or wherever you get podcasts to get evidence-based strategies you can use right now. Other coronavirus episodes so far address isolation, loneliness and rising to the (unasked for and un-sought) challenge. 

A 2016 collaboration between music therapists and the UK soundscape band Marconi Union  resulted in Weightless, a 8-minute composition that was demonstrated in a small research study to reduce blood pressure, heart rate, cortisol levels and for some participants, their anxiety rating by as much as 65%.

Weightless became so popular as a aid to relaxation and sleep that the 10-hour version has logged over 10 million views. 

Will you love it? There's only one way to find out. 

Years ago, when my kids were little, I thought it might be cute to get a sticker for my minivan that read "MultiTasking Mommy", or better - a personalized license plate, but couldn't make it work with 7 characters. After further thought, I realized that announcing that I could be multitasking while driving with children in car was more terrifying than funny. But my tendency to try to multitask didn't go away. I'm not alone. 

We live in Distractionlandia, with a thousand things clamoring for our attention - certainly from that device in your pocket if not from the back seat of your car. The pull to do 2, 3, 4+ things at once is ever-present, including for those of us who are supposed to know better. We multitask with and without awareness of doing so. Some people claim that they're more effective when multitasking. I used to be one of those people, but not any more. 

While I still find myself multitasking all too often, it does help to understand what's really going on in the brain. Notice, refocus on one thing at a time. Notice, refocus. Lather, rinse, repeat. 

Dr. Sanjay Jupta, a truly great explainer, on multitasking. 

Every find yourself reading about mindfulness, brain training, relaxation, guided imagery, stress management or meditation, and feel like there's just too much to choose from? Where should you start? What's the best approach? Do you have to sit and meditate for 20 minutes twice a day? What if you start and then forget to do it?
.
​Ah, you got to love the mind...just never shuts up, does it?

It's not that complicated or fancy. You breath, you relax your body, you notice when your mind wanders and bring it back, again&again&again&again. You hang in there with yourself, repeatedly interrupting the inevitable stream of self-criticism, self-judgement and negative yack, refocusing over and over for a few minutes. Daily practice is great, but don't sweat it if you forget - simply begin again.

Here's a short list of audio recordings of the basic practices, plus a few suggestions for how to get started and keep going. 

If you/someone you love has ADD/ADHD - Congratulations! Welcome to the club! 🤝 Now, how to deal with your wonderful 🐒🧠?

STEP 1. Get A Good Map - Learn About ADHD [note: this is an ongoing project]

Step 1B: Learn by listening to PODCASTS 🎧

Who doesn’t love a good podcast? Okay, some people don’t get into them, but for many of us, it can actually be easier to get engaged by listening rather than reading. Plus, podcasts (and audiobooks) let you move - super-helpful for keeping those attentional circuits in the brain active. I like to listen while folding the laundry, weeding the yard, walking, making the bed, etc. etc.  It’s one way to get through imbortant chores (important but boring).  

But there’s crazy lots to listen to out there – how do you choose where to start?  Suggestion – do a John Wooden and go for the fundamentals: Dr. Ari Tuckman’s ‘More Attention, Less Deficit’ series on understanding adult ADHD and Executive Functioning and success strategies. Originally done as a companion to his excellent book (same title), Dr. Tuckman lays out abstract ideas in an easy-to-grasp manner, with each short (8-12 minutes) episode building on the previous info, so be sure to start at the beginning with the initial episodes. BTW, he’s a  guy with a dry sense of humor, so hang in if he seems less than entertaining at first. More Attention, Less Deficit, on  iTunes, at adultadhdbook.com or simply search from your podcast app.

****October is ADHD Awareness Month!***** 
If you/someone you love has ADD/ADHD - Congratulations! Welcome to the club!

Now what do you do? 
Well, there are 4 general steps to managing ADHD, each of which has a number of smaller steps within it. During October, I'll try to hit as many as I can. *BTW, notice the realistic expectation setting just then? I have to practice what I preach! 😉 
 STEP 1. Get A Good Map - Learn About ADHD (this will be an ongoing project)
Today's Tip: Step 1A. Read the SOLID stuff, from experts - people who know what they're talking about and can explain things clearly. Learn about executive functioning and self-regulation, and how it applies to you. If the book you're reading has self-reflection questions or other workbook type of exercises, trying doing some! Writing out your answers is  more effective than doing it in your head.
💡
Not sure who to read? Look for names like Tuckman, Barkley,  Nadeau, Solden, Sakarsis, Orlov, Brown, Ramsey, Ratey, Hallowell, etc. Clinicians, researchers, educators and coaches - folks who have devoted the years of their lives to understanding and helping people with ADHD. 
📚
Those books are part of my office library. Despite having a fancy degree from a fancy university, I knew very little about ADD/ADHD & even less about ADHD in adults when I started working with ADD college students in 2002. The folks above were my teachers, and I've had the pleasure of meeting some of them at conferences over the years since. 
​Follow me on Instagram @drlauraforsyth for more!

If you're a recently diagnosed ADHDer, or love one, or have been diagnosed for a while and are (still) wondering what to do to deal with it, I'll be posting guidelines and tips specific to adults with ADD/ADHD during the month of October. Follow me on Instagram @drlauraforsyth for more!

Laughter heals. Laughter makes us feel better. Laughter lifts us up. Laughter empowers us in the face of worry and uncertainty. Laughter can help restore our emotional balance and our faith in humanity. Laughter helps us bear stress. Trully, it can.

But what to do when your emotional-balance-and-faith-in-humanity could really use a tune-up, but there's nothing all that funny going on?

Practice laughing.  Make it happen on purpose. Doesn't matter whether you're feeling it at first, doesn't matter if it seems like faking it, doesn't matter if it takes a while.  Our emotional brain is kind of naive - sorry, but it's true. The cortical processes underlying emotional reactions aren't rational and can be pushed around by what we're exposed to.  You already know this, of course - that's  why emotions are contagious. Use it as a force for good - practice laughing. 

How? Time-honored method - get with someone else who’s laughing. No one like that handy? No problem, there’s always YouTube! Suggestion - go for silly and popular. Silly is good, the emotional brain likes silly. Popularity means easy, and easy is awesome.

Example below. Did it go viral? Heck yeah.

There's a great line in the sci-fi novel "Babylon's Ashes", #6 in James S.A. Corey's kickass The Expanse  series (season 2 of Syfy's very entertaining TV adaptation is soon to drop), where a ship's captain, trying to decide on a course of action under perilous circumstances while wrestling with self-doubt and guilt about her previous choices, is asked, "What's the magic word?" 

Huh? Magic word?

Turns out, the magic word is "Oops".

As in, "Oops, I made a BIG mistake", "Oops, I didn't realize/look closely enough/think it through before I acted/know what I didn't know", "Oops, that didn't work out the way I really thought it would", "Oops, I dropped it and it broke into a million pieces.", etc. 
​
An overarching theme (ooh, big-time Lit class!) in Babylon's Ashes is that big decisions must always be made without enough information to be completely certain of the outcome. In fact, the character who is the most sure of himself makes choices with catastrophic consequences, then when things go to hell, justifies his own actions and blame everybody else. He's got responsibility, but no accountability and for sure, no compassion. Everybody suffers because of this jerk.

You can use "Oops" as a key to unlock the door of taking responsibility without being crushed by blame or immobilized by uncertainty. "Oops" is not about trivializing mistakes. Rather, it's about allowing yourself to admit that you missed the call/blew it/dropped the ball/didn't realize/got too anxious to think/spaced out/was too preoccupied with ____/was an idiot/didn't know what you didn't know, etc., etc. etc. Then, allowing yourself to keep on keeping on, learning as you go. There's always going to be another decision to be made or action to be taken. Being mired in indecision and avoidance doesn't get you off the hook, it just makes you feel helpless.

Forward we go - doing the best we can with what we've got at the time. 
 
Very handy, that "Oops". 

​A February 2016 article, "MAP training: combining meditation and aerobic exercise reduces depression and rumination while enhancing synchronized brain activity", in the journal Translational Psychiatry describes what must surely be one the most simple and straightforward treatments for depression around.

The program: one-hour sessions twice a week: 20 minutes of basic focused attention meditation, 10 minutes of very slow walking meditation, then 30 minutes of aerobic exercise on a treadmill with 5 minute warmup / 20 minutes at 'moderate intensity' and 5 minutes cool down. After eight weeks, participants reports an average 40% reduction in their depression symptoms.  

If an antidepressant medication could reliably reduce symptoms by 40% it would be hailed as a wonder drug!  Hmmm...

• NYT article
• Translational Psychiatry ​article

Making decisions - yes/no, stay/go, change/don't - is hard. It’s challenging to think things through objectively and all too easy to feel confused. You might get stuck thinking endlessly until your head fogs up, then just avoid the whole issue as long as possible until circumstances force you to respond, often with fewer or less desireable options that may have been available earlier.

When you need to make a decision, particularly about a possible action or change, use the power of writing.  Laying out the pros and cons of both sides in writing will help you clarify your concerns. Get it out of your head and onto the page to gain perspective. No matter how complicated things are, this method will aid you to make a more informed choice. 

Method:
​1st – List the benefits & downsides of ‘Option A’ (usually keeping things the same) and ‘Option B’ (making the change) in the appropriate quadrant.  Don’t settle for “nothing”.  Ask yourself:  

• What are the good parts/the things I don’t want to give up? List those in A1
• What’s likely to happen (lose, stay stuck with, get worse) that I don’t want if things stay the same? A2
• What could I gain that I want if I make this change? B1
• What makes doing this hard, what am I afraid might happen? B2

2nd - Look at each item and consider:

• How big a deal is this? How important is it to me? (1-5, S/M/L, whatever) The longest list isn't necessarily the most important. The value of a particular can outweigh the number of items. 
• Is this a short-term thing? A long-term thing? Some consequences don’t show up until later, or change over time.  You could even do one version for short-term and another for long-term - notice what changes.

3rd - Are there things you don’t know? Tip: worries, a.k.a. "what ifs?" often can be turned into questions.  Write those down - how can you find out?  

Finally - evaluate - Which side weights more, particularly in the long run?

Remember - rarely is there a ‘perfect’ choice where everything is good and everyone is satisfied. Life is messy. Be brave! Aim to act like your best self.  

From the esteemed Andrew Weil, MD, a breathing exercise that activates your parasympathetic nervous system, counterbalance to our usually-way-too-active sympathetic nervous system (producer of the famous fight/fight/freeze response). Dr. Weil prescribes four rounds of 4-7-8 breathing to shift out of tension into calm and even sleep. 

​In the midst of what is surely the most bizarre election season in living memory, perhaps it would be helpful to review some old advice on how to maintain one's mental stability when it seems that the world really is in the handbasket, headed down to a very hot place.

And by old, I mean old.  The Yoga Sutras of Patanjali are presumed to be at least 1,600 years old, maybe more. Yet the advice in Sutra 1:33 about how to not get all freaked out by what other people do or say feels quite fresh and relevant.  

From Christopher Isherwood's translation:

and T.K.V. Desikachar explains Sutra 1:33 like this:

Notice the term "cultivate" in the first quote.  That's a reminder that growth takes effort and attention over a period of time. It's worth it, though, since friendliness is the antidote to jealousy, compassion allows us to be supportive rather than judgmental, delight lifts us up when envy or comparing ourselves to others drags us down and indifference (not paying too much attention) frees us from getting worked up with worry or outrage.

And if at first, you don't succeed, no worries - there will always be plenty of opportunities to practice!

One day you finally knew
what you had to do, and began,
though the voices around you
kept shouting
their bad advice--
though the whole house
began to tremble
and you felt the old tug
at your ankles.
"Mend my life!"
each voice cried.
But you didn't stop.
You knew what you had to do,
though the wind pried
with its stiff fingers
at the very foundations,
though their melancholy
was terrible.
It was already late
enough, and a wild night,
and the road full of fallen
branches and stones.
But little by little,
as you left their voices behind,
the stars began to burn
through the sheets of clouds,
and there was a new voice
which you slowly
recognized as your own,
that kept you company
as you strode deeper and deeper
into the world,
determined to do
the only thing you could do--
determined to save
the only life you could save.

~ Mary Oliver

Ever wonder if you should be taking some kind of vitamins? Trying to research this topic can be a fast train to Confusion Land, where hype, unsupported claims and contradictory information abound. 

Don't give up, though - supplementation can help, especially when you're just starting or are in the middle of improving your diet and lifestyle - going for less of the stuff that comes out of a sealed package or can and more of that stuff that actually grew in the ground.  Interested in suggestions?

​"The word that allows yes, the word that makes no possible.
The word that puts the free in freedom and takes the obligation out of love.
The word that throws a window open after the final door is closed.
The word upon which all adventure, all exhilaration, all meaning, all honor depends.
The word that fires evolution's motor of mud.
The word that the cocoon whispers to the caterpillar.
The word that molecules recite before bonding.
The word that separates that which is dead from that which is living.
The word no mirror can turn around.
In the beginning was the word and that word was

CHOICE."

 Tom Robbins ~ Author, ​Still Life With Woodpecker

Manage verb "to succeed in doing something, especially something difficult" (from the Cambridge Dictionary).  

Managing ADHD is a process, not something done once, but every day. Naturally, some days go better than others.  If you've just been diagnosed or even if you've known for a while but want a refresher, check out these basic guidelines for managing ADHD.