Category Archives: Adult ADD

Untreated Psychiatric Disorders Can Affect Couples Counseling

Posted on by Erika Boissiere
29 Oct

We all come to couples counseling for a variety of reasons. As a couples therapist, I often hear similar complaints from clients, “he just doesn’t listen to me,” or, “we fight all the time.” Also on the list, “we’ve stopped having sex,” or “can you just change her?” While couples counseling can be the perfect venue to give you tools and tips on how to communicate better, resolve conflict differently, liven up your sex life, and make important relational changes, there are a few things that will stop the process right in its tracks.

Untreated psychiatric disorders will make couples counseling incredibly difficult. If you’re struggling with depression, anxiety, ADHD or any other psychiatric disorder, it is imperative that you get individualized treatment, first. Treatment typically includes a thorough assessment by a specialized professional, either a psychiatrist or a therapist in that particular field of study. If you don’t get individualized treatment first, your couples therapist will give you tools and tips that either you’re unable to utilize (yet). Your therapy sessions will be met with either failed attempts or frustration. All things that you want to avoid as you venture down the vulnerable journey of couples therapy.

While it is the hopes of many clients to change their relationship, such as wanting better sex, more aliveness, stronger communication, less fighting, and so on – the very first step is to take a look at yourself. If you are struggling independently, your treatment comes first , before couples therapy.

One example to illustrate this point is the classic case of someone struggling with undiagnosed adult ADHD. One partner complains that the other is late, lacks of organization, has the inability to prioritize and is unaccountable. It is easy for the other to potentially pin this on characterological factors, saying things like, “he’s just like this,” or “he’s selfish and doesn’t think of me.” However, what if your partner has undiagnosed ADHD? Your partner could be struggling with something outside of their control.

Another excellent example to display the importance is that of undiagnosed depression. A partner may complain that their spouse “never gets out of bed,” is “irritable,” often is “tired and lacks motivation.” Again, these are all signs that could point to a diagnosis of depression – but what if your spouse is convinced that it is because “you just don’t care,” or “you’re lazy.” Your spouse will end up persecuting you on behaviors that may have be out of your control.

Clients struggling with reoccurring symptoms that seem out of the ordinary may need individualized treatment. Through a thorough assessment, skills and coaching, the client has the ability to make individual changes that will impact their relationship. Once the psychiatric disorder is stabilized, couples counseling can be extremely beneficial. Skills such as communication, conflict stabilization, sex, and intimacy issues can be addressed – the very ingredients that help couples and relationships have stronger and more intimate connections.

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For more articles and information from Erika Boissiere, MFT – Founder of the Relationship Institute of San Francisco, please visit www.trisf.com or  call 415-519-6446.

Overcoming Adult ADHD with Positive Visualization

Posted on by Phil Boissiere
09 Oct

One very important technique for overcoming adult ADHD is Positive Visualization. For adults with ADHD years of negative outcomes and self-defeating thoughts build up to become giant roadblocks that lead to procrastination. When people with ADHD are confronted with negative or overwhelming thoughts about a project or task, it causes all other stimulus in the environment to become very distracting and even enticing. Often, people will find themselves doing things that they like even less than the task they need to be doing. For example, doing dishes or cleaning the bathroom, rather than sending a quick email to their boss.

One way to begin overcoming this, is to integrate Positive Visualization at the beginning or at the scheduled time to work on a given task or project. Positive Visualization involves thinking about the rewards that will come from completing the task. These may be things like material success, praise from others, or even intrinsic factors like the feeling of accomplishment. By doing this, it tends to excite the brain and bolster the production of dopamine,  making it more likely that you will engage and complete the task.

This is just a brief overview of a very powerful tool for managing procrastination. There are more complex techniques to practice with this and bring about real change in your life. However, by starting with this very simple application, you will likely start to find some success.

Success and Focus for Entrepreneurs with ADHD

Posted on by Phil Boissiere
27 Jul

What makes an adult with ADHD like Richard Branson so successful? Why do some adults with ADHD struggle to succeed in their career? There are many factors to this complex question. However, there is one overriding principal that allows entrepreneurs with ADHD to find success, and it is called focus. Focus is a big word for adults battling ADHD. The good news is that focus can be greatly improved through treatments like Cognitive Behavioral Therapy (CBT), skills coaching, exercise, and medication management.

CBT specifically, is focused on treating ADHD by teaching skills that improve executive functioning, decrease anxiety, and help provide direction. For many entrepreneurs it can mean the difference between an office full of half finished projects and a handful of very successful ventures. The process and techniques work to activate the brain in a way that helps boost an individuals ability to focus and execute their innovative ideas. San Francisco and the Silicon Valley are full of incredible people doing amazing things. Unfortunately, there are many standing on sidelines struggling to break through due to their Adult ADHD. With the right help, most of these people can make the changes they need to treat their ADHD and find the success they deserve. If this article resonates with you, then reach out, find support, and take control of your Adult ADHD and your career.

 

5 Steps to Manage Your Diet

Posted on by Phil Boissiere
25 Jun

Tired of being a slave to your cravings? Tired of using food to manage your stress? Want to tune up your physique and mental health? Follow these 5 steps to manage your diet (with your MDs permission of course):

1. Understand your brain: The best way to understand why your brain is pushes you to eat things you want to is to look at at adults with ADHD. People with ADHD have an underproduction of dopamine in their brains, making it hard to control impulses. Food, especially carbohydrates, provide a rush of dopamine making binging immediately gratifying. You may not have ADHD, but when you are stressed, tired, or down,  your brain is craving dopamine and a slough of other neurotransmitters.

2. Don’t skip meals: It’s simple, if food provides a release of dopamine, skipping meals will certainly create a deficiency and subsequent craving.

3. Eat multiple small meals: Eating small meals every 3 hours helps regulate blood sugar, neurotransmitters, and stimulates the metabolism.

4. Exercise: Exercise increases the baseline level of dopamine and norepinephrine in the brain. If your baseline production of dopamine is higher, you are less likely to crave the rush of dopamine following a plate of carbs. This is especially important for adults with ADHD.

5. Stay motivated: Staying motivated is a bit more complex. There are many variables that go into the reasons why we start and maintain changes to our diet. For some it is cosmetic, for some it is mental, for some it is physical, whatever the reason, the motivation lies in our thoughts and feelings. By becoming aware of our thoughts and their relation to our feelings, we can ultimately change our behaviors. This is the basis of the powerful therapeutic approach Cognitive Behavioral Therapy (CBT). Sometimes our thoughts don’t serve us well and prevent us from making the changes in our lives we want.

Lisa Ling Diagnosed with ADHD

Posted on by Phil Boissiere
16 Jun

The journalist Lisa Ling has been diagnosed with ADHD. Lisa was working on a story showcasing the diagnosis and treatment of ADHD and found that she met many of the typical symptoms of ADHD. Upon proper assessment, it turned out she does have adult ADHD. Her willingness to be open about her recent diagnosis is important for many reasons. First, she is 40 years old, which showcases how an adult can go undiagnosed until well into their career. Second, she is successful, which shows that ADHD does not necessarily dominate an individuals life. Like any disorder, the severity can very. Third, Lisa Ling is a woman, which is important for increasing the awareness that ADHD effects women also.

Lisa Ling found that unless she was working and actively engaged in interesting pursuits, she would struggle. This is often the case for many adults. Escaping into work or other stimulating behaviors to manage untreated adult ADHD. Hopefully Lisa’s story will inspire and empower others to take charge of their adult ADHD.

 

2 Reasons to Treat ADHD with Exercise

Posted on by Phil Boissiere
13 Jun

Symptoms of Attention Deficit Hyperactivity Disorder (ADHD for short, or casually called ADD) can be partially relieved by simply exercising. Most people know that exercise is good for their bodies and can make you feel good, but few people know that exercise actually activates the same pathways in the brain as stimulant medications.

Stimulant medications for ADHD target dopamine and norepinephrine, two very important chemicals in the brain for regulating attention. Fortunately, exercise naturally increases levels of dopamine and norepinephrine, making it a very important part of treatment for adults and children with ADHD. The effect that exercise has on increasing dopamine and norepinephrine is immediate, but must happen regularly to provide maximum benefit.

The second reason is that exercise, especially complex movements like Karate or Soccer, increases activity in the cerebellum. The cerebellum is paramount in controlling the flow of information in the brain. Adults and children with ADHD tend to have smaller cerebellums, which compound attention struggles. In other words, by exercising regularly individuals with ADHD are providing themselves with a double whammy of positive neurological and physiological benefit.

This brief article is not a call to stop taking ADHD medications, rather it is a call for doctors and patients to take an active role in doing everything possible to treat ADHD. The body of evidence supporting the combination of medication and Cognitive Behavioral Therapy in the treatment of ADHD is extensive and widely accepted. It’s time we give the same credence to the value of exercise in the treatment of ADHD.

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Phil Boissiere, MFT specializes in the treatment of ADHD in adults and couples in San Francisco, Menlo Park, and the Silicon Valley. He is available for interviews and article contributions on the topics of Cognitive Behavioral Therapy, Adult ADHD, Group Psychotherapy, or Teen Drug Prevention.

ADD, ADHD, or AD/HD, Which is it and Why So Many Names?

Posted on by Phil Boissiere
27 Apr

When looking for information related to Adult ADHD, one will quickly find considerable information using terms such as ADD, ADHD, or even AD/HD. This creates a lot of confusion about the correct terminology and name of the disorder. The correct name is Attention Deficit Hyperactivity Disorder (ADHD). There are three subtypes of ADHD, primarily inattentive type, primarily hyperactive type, or combined type. Even using the term “Adult ADHD” is a bit misleading as it is not an actual disorder name, but more of a casual classification to highlight adults with the disorder.

One reason that there is so much use of incorrect terms like “ADD” by prominent people, is that the disorder is actually poorly named to begin with. Anyone dealing with ADHD as an adult or a child will tell you that it is much more than having trouble focusing. The core neurological issue behind ADHD is an under functioning of the Prefrontal Cortex, mainly an underproduction of the neurotransmitter Dopamine. This leads to trouble with stimulus selection (i.e. focusing one’s attention) and/or trouble selecting responses to stimuli (i.e. behaviors). When someone’s Prefrontal Cortex is functioning properly they are able to create a very important “pause” that allows them to have a choice in what to focus on and how to respond. Further compounding these issues are the social and psychological stressors that accompany repeated failures to perform. These stressors (i.e. problems with friends/family, occupational struggles, etc.) lead to engrained emotional responses and thought patterns that foster shame, guilt, and lack of confidence. When anyone (with ADHD or not) is feeling shameful and lacking self confidence, they are less apt to perform well in social and occupational settings.

If we are going to move the field of treating adults with ADHD forward, we may want to think about broadening the scope of the name of the disorder. Something that incorporates terms like executive functioning, stimulus selection, motivation, or performance, may help. However, we are very far away from the DSM team coming up with a fresh new name for this disorder. Until then, we must expect/demand that leaders in the field use the correct terminology. For example, Daniel Amen’s new product is called Healing ADD at Home in 30 Days. There are a multitude of problems with this title, from the fact that he uses the term ADD to making a claim that it can be “healed” in 30 days. ADHD is life long disorder that when treated appropriately can be managed tremendously well. However, saying things like “healed” can create false expectations that ultimately lead to unattainable goals.

There are no examples of someone telling a diabetic that they have a “sugar problem” and that they can “get over it” in a few weeks. Adults and children with ADHD deserve the same level of respect when talking about their disorder.

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Phil Boissiere, MFT specializes in the treatment of ADHD in adults and couples in San Francisco, Menlo Park, and the Silicon Valley. He is available for interviews and article contributions on the topics of Cognitive Behavioral Therapy, Adult ADHD, Group Psychotherapy, or Teen Drug Prevention.

Overview of CBT for Adult ADHD

Posted on by Phil Boissiere
15 Apr

Cognitive Behavioral Therapy approaches for the treatment of Adult ADHD are designed to help people overcome deficits in executive functioning. Executive functions are critical for effective time management, organization, and planning. CBT also improves stress management, emotional regulation, and impulse control.

CBT has been established as an effective treatment for adults with ADHD who suffer from co-existing anxiety and depressive disorders. A major national study showed that 51% of adults with ADHD suffer from anxiety and 32% suffer from depression. This means treatments that incorporate CBT for anxiety and depression may be helpful to many adults with ADHD, even though they are not designed specifically to address the symptoms and impairment associated with ADHD. However, the skills training associated with specific CBT programs for ADHD adults, tend to show the greatest results.

Treatments that address executive dysfunctions aid adults in developing more adaptive thought patterns about how to go about planning, organizing, and gain more effective skills. For example an adaptive technique that utilizes CBT is to break down long or unpleasant tasks into manageable parts, while utilizing positive visualization. Positive cognitions(thoughts) and positive behaviors tend to reinforce one another. In other words, as a person becomes better at managing time, they also come to have more positive beliefs and thoughts about themselves. This pattern acts like a generator of positive/adaptive thinking and effective skill development.

Adult ADHD Relationships

Posted on by Phil Boissiere
03 Dec

There is considerable information out there about adult ADHD relationships. Unfortunately, the bulk of this information focuses on the negative effects adult ADHD has on relationships. I think it is of equal importance to give some attention to how adult ADHD can actually prevent the person with ADHD from being empowered in their relationship. This lack of empowerment can limit one’s ability to change or even get out of a bad relationship.

I see this often with clients who “come out of the ADHD fog” as I have named it. When adults are too distracted, forgetful, or struggling to maintain work or school performance, they often don’t have the psychological resources to address their romantic relationships. Something that also makes this problem worse, is that most adults with ADHD have considerable shame and self-doubt, which leads them to believe that any relationship struggles they face, are their own fault. It is true that adult ADHD can wreak havoc on relationships. However, this does not give clemency to the non-ADHD partner, nor does it mean that issues unrelated to adult ADHD also plague some relationships.

It is an honor to accompany my clients on their journey towards change. We all deserve healthy, symbiotic, and supportive relationships. Those people challenged by adult ADHD need to know and believe that also, so they may advocate for themselves and shape their lives in a positive way. There are many people walking around San Francisco that I have worked with around adult ADHD relationships through Cognitive Behavioral Therapy (CBT), skills training, and relationship work. To know that there are people who are out of the fog and living life to it’s fullest, and know that I touched their lives, gives me a great big smile inside.

CBT and Adult ADHD

Posted on by Phil Boissiere
18 Nov

There are a multitude of treatment approaches for adult ADHD. However, research has shown that a combination of Cognitive Behavioral Therapy (CBT) and Skills Training is most effective in the treatment of adult ADHD. It is important to note that ADHD is caused by an under stimulated portion of the brain, that in-turn leads to an underproduction of Dopamine. In order to adequately address this under stimulation, most adults with ADHD will need to explore medication with a trained psychiatrist.

When stimulant medication, CBT, and Skills Training are combined to address adult Attention Deficit Hyperactivity Disorder, people tend to have the best results. San Francisco and the Silicon Valley at large (Menlo Park, Palo Alto, Cupertino, Sunnyvale etc.) are full of people trying to reach optimal productivity and success. Unfortunately, the majority of psychologists, psychotherapists, and even medical doctors do not have this same dedication to productivity and results. In fact most do not adhere to effective treatments, backed by research when treating ADHD in adults. This can lead to tremendous frustration as life seems to continue to pass people by while in treatment.

I partner with only a handful of psychiatrists who have the knowledge, experience, and careful approach needed to work with ADHD. When a psychotherapist partners closely with a patients doctor, the results tend to be achieved more quickly and tend to last.

I welcome your questions and about adult ADHD and if I cannot meet with you due to scheduling etc., I will work to help you find an ADHD specialist in the San Francisco Bay Area to meet your needs.