Recently a freshman undergrad with inattentive attention deficit hyperactivity disorder (ADHD) asked, “How do I stay awake when I try to write my papers? I fell asleep again with my assignment last night, and now I’m running behind. This keeps happening to me.”
People with various types and degrees of ADHD find the condition makes it difficult to predict how they will function on a given day. The extremes of the spectrum range from “on” (functioning optimally) to “partially on” (functioning enough to do what is necessary in daily life) to “off” (barely functioning). The unevenness of symptoms can be terribly frustrating and makes it difficult to plan and carry out basic daily life activities.
Dr. Edward M. Hallowell, a child and adult psychiatrist in Sudbury, Massachusetts and founder of The Hallowell Center (a counseling and diagnostic center for people with ADHD and other conditions that affect concentration, attention, learning, and memory) and Dr. John J. Ratey, a professor of psychiatry at Harvard Medical School, co-authored the 1994 groundbreaking ADHD canon Driven to Distraction. Eleven years later, in Hallowell and Ratey’s Delivered from Distraction, the authors bluntly describe the unevenness of symptoms in their checklist of “disadvantageous characteristics” of ADHD:
Inconsistent performance despite great effort. People with ADHD do great one hour and lousy the next, and great one day and lousy the next, regardless of the effort and time in preparation. They go from the penthouse to the outhouse in no time!
Some with ADHD hesitate to make plans when they are on. They worry that when it comes time to follow through, they will feel too off to deliver. If only symptoms came as predictably as a 9-5 Monday through Friday schedule.
Part of the unpredictability is the many variables that can affect the severity of symptoms that go with neurobiological conditions like ADHD.
ADHD risk management: Ounces of prevention
Below is a series of questions to ask yourself if fatigue is getting in the way of completing your assignments:
How interesting to me is my writing topic?
This question might sound dumb to you and painfully obvious, but people with ADHD tend to have special interests that captivate their attention, sometimes to the point of overfocusing on their special interests–and away from the task at hand. When people with ADHD must write about a topic they perceive as less interesting or uninteresting, writing can seem impossible. Most people find it more difficult to write about topics of lesser interest, of course, but with ADHD, the problem intensifies.
How much sleep did I get last night?
At least 7-8 hours per night is the recommended amount for adults, although for teens it is actually closer to 9 hours per night.
What did I eat today? Did I eat today? When did I last eat? How much protein did I eat today?
Blood sugar fluctuations can have a significant impact on ADHD symptoms. People with self-regulation disorders often “forget” to eat when they get involved in certain activities—especially enjoyable ones. When you start the day, a high-protein breakfast is best. Eat what some people might consider “dinner” foods when you first wake up. For example, reheat a chicken breast from last night’s dinner. The worst things to eat are bagels, cereals, and muffins (“muffin” is a euphemism for “cake”). Eating refined carbohydrates is the equivalent of taking a sleeping pill, suggests ADHD expert Daniel Amen. You will likely nod off.
How much water am I drinking?
Mayo Clinic recommends eight 8-ounce servings of water per day.
Have I been under more stress in school/work/my personal life lately?
Stress tends to make most chronic conditions worse.
Are my hormones fluctuating?
Hormone fluctuations can worsen any chronic conditions women already have. Some research has claimed that premenstrual syndrome can include approximately 150 different symptoms. I don’t doubt it.
Am I exercising?
When you exercise, you tend to sleep better. With good sleep, your overall functioning tends to stabilize. The worst part? Getting the motivation to start exercising. For people with ADHD, transitioning from one activity to another can be difficult and even disabling on some days. That’s why many people with ADHD cannot multitask (I should qualify: Cannot multitask and get things right).
Do I have small “bursts” of energy within a day where I am calm, focused and clear minded?
If possible, do small parts of your project/write notes about ideas when you feel those bursts of energy. You may not remember your ideas later, so write them down when they come to you.
Am I eating foods that cause inflammation?
People with ADHD are prone to coexisting allergies and food sensitivities. Eating foods that cause inflammation can also inflame behavior. Our next post will outline specific anti-inflammatory foods that are recommended for people with ADHD (and other conditions that affect self-regulation).
Please visit our site for part 2 of ADHD and fatigue, when we follow up with more information and other concrete suggestions to help you manage symptoms of fatigue.
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